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Only When They Seek: Exploring Supervisor and Resident Perspectives and Positions on Upward Feedback
Subha Ramani1, Rachelle C W Lee-Krueger, Amanda Roze des Ordons
1Dr. Ramani: Associate Professor of Medicine, Harvard Medical School, Boston, MA, and Director, Program for Research, Innovations and Scholarship in Education, Department of Medicine, Brigham and Women's Hospital, Boston, MA. Dr. Lee-Krueger: PhD Candidate, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada. Dr. Roze des Ordons: Clinical Associate Professor, Department of Anesthesiology, Pharmacology and Therapeutics; and Divisions of Critical Care Medicine and Palliative Care, Department of Medicine; University of British Columbia, Canada. Dr. Trier: Assistant Professor, Department of Physical Medicine and Rehabilitation, Queen's University, Kingston, Ontario, Canada. Dr. Armson: Professor, Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Dr. Könings: Associate Professor, Department of Educational Development & Research and Graduate School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; and Dr. Lockyer : Professor Emerita, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Trainees fear negative consequences when giving supervisors feedback, leading to avoidance. Emphasizing mutual growth and supervisor receptiveness can encourage upward feedback for improved medical education.
Area of Science:
- Medical Education
- Healthcare Professional Development
- Communication in Healthcare
Background:
- Verbal feedback from trainees to supervisors in medical education is infrequent despite its value.
- Existing research primarily focuses on narrative comments in resident evaluations of supervisors.
Purpose of the Study:
- To explore supervisors' and residents' beliefs and experiences regarding upward feedback.
- To gather recommendations for initiating and facilitating effective upward feedback conversations.
Main Methods:
- Thematic analysis of transcribed, anonymous focus group data from internal medicine residents and clinical supervisors.
- Utilized Positioning Theory to analyze key concepts related to verbal upward feedback.
Main Results:
- Identified themes included beliefs about lack of impact and risks, experiences of avoidance and nonspecific language, and recommendations for clear expectations and growth focus.
- Participants assumed learner-teacher roles, contributing to residents' concerns about adverse consequences and supervisor receptiveness.
Conclusions:
- Learner-teacher dynamics and perceived risks hinder upward feedback in medical training.
- Supervisors emphasizing mutual professional growth and actively seeking feedback can encourage trainees to provide it.
- Recommendations offer a foundation for faculty development programs to enhance upward feedback practices.
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