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Published on: September 4, 2019
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Feedback Culture Perceived by Trainees in an Academic Institution: A Mixed Methods Study
Uma Padhye Phatak1,2,3, John Encandela1,4, Michael Green1,4,5
1Yale School of Medicine.
Hospital Pediatrics
|October 4, 2023
Summary
Resident trainees perceive a less favorable feedback culture compared to fellows, impacting skill acquisition. Efficiency demands and a culture prioritizing courtesy over candor hinder feedback quality, particularly in pediatric subspecialties.
Area of Science:
- Medical Education
- Healthcare Quality Improvement
- Professional Development
Background:
- A robust feedback culture is crucial for developing essential patient care skills.
- Deficiencies in institutional feedback mechanisms can impede trainee competency acquisition.
- This study addresses the perceived feedback environment among resident and fellow trainees.
Purpose of the Study:
- To assess the feedback culture as perceived by resident and fellow trainees.
- To identify factors influencing the quality and quantity of feedback within an institutional setting.
- To compare feedback perceptions between residents and fellows using a mixed-methods approach.
Main Methods:
- Anonymous survey assessing 7 feedback constructs (e.g., credibility, quality, delivery) on a 7-point Likert scale.
- Quantitative analysis included Fisher's exact tests and multivariable linear regression.
- Qualitative data from semistructured interviews were analyzed using the constant comparative method.
Main Results:
- Fellows reported more favorable feedback perceptions than residents across 6 of 7 constructs (P < .05).
- Hispanic ethnicity and female gender were linked to lower scores in source credibility and constructive feedback, respectively.
- Qualitative themes revealed that efficiency demands and a culture of courtesy over candor negatively impact feedback, especially in subspecialty settings.
Conclusions:
- The feedback culture is less favorable within the residency program compared to the fellowship program.
- The drive for patient care efficiency and a culture valuing courtesy over directness diminish feedback quality.
- These issues are more pronounced when residents train with pediatric subspecialists versus hospitalists.
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