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Ask-Tell-Ask with Bidirectional Feedback Improves Feedback Culture.

Joseph A Dayaa1, Milza Howard2, Winston Li2

  • 1University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. joseph.dayaa@unchealth.unc.edu.

Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
|May 15, 2024
PubMed
Summary

Implementing an Ask-Tell-Ask feedback model enhanced with bidirectional communication significantly improved physician and student perceptions of feedback quality and fostered a more positive feedback culture in psychiatry training.

Keywords:
Ask-Tell-AskBidirectional feedbackFeedbackGraduate medical educationUndergraduate medical education

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Area of Science:

  • Medical Education
  • Psychiatry Training
  • Feedback Models

Background:

  • Effective feedback is crucial for professional development in medical education.
  • Traditional feedback methods may not adequately foster bidirectional communication or actionable goal setting.
  • The Ask-Tell-Ask model offers a structured approach to feedback delivery.

Purpose of the Study:

  • To evaluate the impact of an enhanced Ask-Tell-Ask feedback model on the perception of feedback among physicians and medical students.
  • To assess whether augmenting the Ask-Tell-Ask model with bidirectional feedback improves the overall feedback culture.

Main Methods:

  • The Ask-Tell-Ask model with bidirectional feedback emphasis was implemented on an inpatient psychiatry unit.
  • Attending physicians received training on the model and conducted weekly feedback sessions with trainees.
  • Pre- and post-rotation surveys assessed perceptions of feedback clarity, predictability, actionability, and bidirectionality.

Main Results:

  • Survey ratings for all feedback perception items significantly improved post-intervention (p < 0.0001).
  • Qualitative analysis revealed a shift in feedback culture from constrained and hierarchical to constructive and approachable.
  • The intervention led to statistically significant improvements in the perceived feedback environment.

Conclusions:

  • The Ask-Tell-Ask feedback model, when enhanced with bidirectional feedback, significantly improves how feedback is perceived.
  • This model positively transforms the overall feedback culture in a psychiatry residency program.
  • Emphasizing both giving and receiving feedback is key to enhancing its effectiveness.