Prompting better feedback: investigating the effect of targeted form design on quality of narrative feedback in...

Competency-based medical education (CBME) requires a variety of assessments evaluating resident performance. Assessment form design may influence narrative feedback quality. To evaluate the effect of including targeted written comment prompts in entrustable professional activity (EPA) assessment forms on the quality of narrative feedback in CBME ophthalmology resident trainee assessments.

Transition to discipline (TTD) assessment data from three distinct time periods were anonymized; the first 2 groups contained assessments completed with the original form design, whereas the last group represented assessments completed after the introduction of revised EPA forms. Written feedback was scored using the Quality of Assessment for Learning (QuAL) score. One-way ANOVA and a Tukey post hoc test were used to compare mean QuAL scores of each group.

One-thousand one-hundred and forty-five assessments were analyzed, including 680 Original EPA forms, 322 intermediate forms, and 143 revised forms. QuAL scores significantly increased after revisions were made to the assessment form, with original, intermediate, and revised form mean QuAL scores of 2.14 ± 1.76, 2.77 ± 1.75, and 4.33 ± 1.11; P < 0.001 for all comparisons, respectively.

Revising EPA form design to include targeted prompts and examples of evidence-based coaching words to guide written comments results in higher-quality narrative feedback in CBME assessments.