Comparing the Quality of Narrative Comments by Rotation Setting

Area of Science:

• Medical Education
• Surgical Training
• Feedback Quality

Background:

• Distributed medical education is increasing in postgraduate training.
• Understanding variations in feedback quality across different training sites is crucial.
• Narrative comments are vital for trainee assessment and Clinical Competency Committee (CCC) review.

Purpose of the Study:

• To investigate how different rotation settings affect the quality of trainee-directed narrative comments.
• To evaluate feedback quality using the McMaster Narrative Comment Rating Scale (MNCRS).
• To inform strategies for improving feedback consistency and utility in residency programs.

Main Methods:

• Retrospective analysis of 2,469 narrative comments from a Canadian General Surgery Residency Program (2014-2019).
• Utilized the validated McMaster Narrative Comment Rating Scale (MNCRS) to assess comment quality across five domains.
• Employed repeated measures Analysis of Variance (ANOVA) to compare feedback quality across academic, urban tertiary, distributed urban, and distributed rural settings.

Main Results:

• Significant variation in narrative comment quality was observed across rotation settings.
• Academic sites provided more actionable and corrective feedback compared to other settings (p < 0.01).
• Urban tertiary rotation settings yielded consistently lower quality comments across all assessed domains (p < 0.01).

Conclusions:

• Rotation setting significantly influences the quality of faculty feedback provided to surgical trainees.
• Targeted faculty development is essential to enhance feedback quality, irrespective of the rotation setting.
• Standardized feedback training should address both site-specific needs and program-wide objectives for consistent, high-quality narrative feedback.