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From Their Eyes: What Constitutes Quality Formative Written Feedback for Neurosurgery Residents
Chris J Neal1, Steven J Durning2, Rajeev Dharmapurikar3
1Division of Neurosurgery, Walter Reed National Military Medical Center, Bethesda MD, Uniformed Services University, Bethesda, Maryland.
Journal of Surgical Education
|October 24, 2022
Summary
Quality surgical feedback for neurosurgery residents improves when using the Zone of Proximal Development (ZPD) framework. Specific, actionable feedback significantly enhances resident perception of feedback quality.
Area of Science:
- Medical Education
- Neurosurgery Training
- Surgical Skills Assessment
Background:
- Neurosurgery resident feedback quality is not fully understood.
- The Surgical Autonomy Program (SAP) is an intraoperative assessment tool.
- SAP utilizes Vygotsky's Zone of Proximal Development (ZPD) for feedback.
Purpose of the Study:
- Identify themes in SAP written feedback.
- Examine how these themes affect resident perception of feedback quality.
Main Methods:
- Reviewed 2968 SAP entries from 2019-2021.
- Used thematic analysis and constant comparative technique.
- Assessed feedback quality based on resident perception.
Main Results:
- High-quality feedback reported 91.4% when ZPD was used vs. 58.6% when not (p < 0.001).
- Key themes identified: Non-Specific, Specific General Observations, Key Points, Next Steps, Independent Practice.
- Specific feedback categories (Observations, Key Points, Independent Practice) linked to higher quality.
Conclusions:
- Specific feedback on performance, learning, and independence enhances quality.
- Theory-based tools like SAP offer meaningful feedback for neurosurgery residents.
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