Implementation of structured feedback in a psychiatry residency program in Canada: a qualitative analysis study

Area of Science:

• Medical Education
• Psychiatry Residency Training
• Implementation Science

Background:

• Structured feedback is vital for learner progression in competency-based medical education (CBME).
• The R2C2 feedback model is evidence-based but factors influencing its implementation require further study.
• This pilot study examines R2C2 implementation in a psychiatry CBME program.

Purpose of the Study:

• To describe the implementation of the R2C2 feedback model in a psychiatry residency program.
• To identify factors influencing the implementation of the R2C2 model using the Consolidated Framework for Implementation Research (CFIR).

Main Methods:

• A pilot study involving three phases: planning, implementation, and evaluation.
• Fifteen supervisors received training and utilized the R2C2 model with residents.
• Semi-structured interviews with 10 supervisors explored their experiences, analyzed using CFIR domains.

Main Results:

• Qualitative analysis identified four key themes: perceptions of R2C2, implementation facilitators/barriers, fidelity, and intersectionality.
• The CFIR framework structured the analysis of implementation factors.
• Key facilitators included the model's structure, supervisor self-efficacy, educational expertise, learning culture, organizational readiness, and training support.

Conclusions:

• The R2C2 model is a valuable tool for structured feedback in CBME.
• Successful implementation hinges on factors like model structure, self-efficacy, institutional support, and training.
• Further research should investigate learner perspectives and model fidelity.