Evaluating the SPIKES Model for Improving Peer-to-Peer Feedback Among Internal Medicine Residents: a Randomized...

Area of Science:

• Medical Education
• Clinical Communication
• Internal Medicine Training

Background:

• Effective feedback is crucial for clinical performance, yet optimal methods for peer feedback remain underexplored.
• The SPIKES framework, a communication tool from oncology, offers a structured approach to difficult conversations.

Purpose of the Study:

• To evaluate if a concise educational intervention using the SPIKES framework enhances peer feedback quality among internal medicine residents.
• To compare feedback quality in an intervention group receiving SPIKES training versus a control group receiving usual practice.

Main Methods:

• A randomized controlled trial was conducted at an academic medical center.
• Internal medicine residents (PGY1 and PGY2) participated, with PGY2s randomized to the SPIKES intervention or control group.
• The intervention included a 30-minute didactic and refresher emails on the SPIKES framework.

Main Results:

• Junior residents (PGY1s) reported significantly greater extent of feedback (p=0.02), specificity (p<0.01), and satisfaction (p<0.01) from senior residents (PGY2s) who received SPIKES training.
• Response rates were 51% for PGY1 surveys and 42% for PGY2 surveys.
• No significant differences were found in senior residents' self-reported feedback quantity or quality.

Conclusions:

• A brief SPIKES framework educational intervention can improve trainee perception of peer feedback.
• The intervention demonstrated modest implementation requirements and positively impacted feedback extent, specificity, and satisfaction.
• Further research is needed to address limitations and optimize peer feedback strategies in medical education.