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Scalable Coaching and Appreciation Feedback for Optimal Learning and Decision-Making (SCAFFOLD)
Zach Landis-Lewis1, Peter Boisvert1, Farid Seifi1
1Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, USA.
Studies in Health Technology and Informatics
|August 8, 2025
Summary
Scalable Coaching and Appreciation Feedback For Optimal Learning and Decision-making (SCAFFOLD) improves healthcare quality improvement by increasing provider engagement with feedback. This system generates motivational coaching and appreciation messages, enhancing feedback effectiveness.
Area of Science:
- Healthcare Quality Improvement
- Medical Informatics
- Health Professions Education
Background:
- Clinical performance feedback is crucial for quality improvement but often suffers from low healthcare professional engagement.
- Variable evidence exists regarding the effectiveness of traditional feedback methods.
- Lack of provider engagement is a significant barrier to optimizing feedback impact.
Purpose of the Study:
- To introduce Scalable Coaching and Appreciation Feedback For Optimal Learning and Decision-making (SCAFFOLD), a precision feedback system.
- To enhance provider engagement and feedback effectiveness through improved performance feedback reports and dashboards.
- To assess the feasibility and function of SCAFFOLD in a large-scale quality improvement initiative.
Main Methods:
- Development of the SCAFFOLD system to generate messages with high motivational potential.
- Implementation of SCAFFOLD within a national-scale perioperative quality improvement consortium over six months.
- Analysis of message generation and types (coaching vs. appreciation) for anesthesia providers.
Main Results:
- SCAFFOLD generated 21,776 messages for 4,550 anesthesia providers.
- 94% of messages were coaching-focused (20,391), while 6% were appreciation messages (1,385).
- The system demonstrated feasibility for large-scale message generation.
Conclusions:
- SCAFFOLD offers a feasible approach for generating tailored coaching and appreciation feedback messages.
- The system enhances feedback emails, reports, and dashboards to boost provider engagement.
- Precision feedback systems like SCAFFOLD show promise for improving the effectiveness of quality improvement strategies.
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