The Quality of Written Feedback Provided by Pediatric Hospitalists: A Needs Assessment

Effective written feedback is essential for trainee assessment in graduate medical education but is often of poor quality, leading to dissatisfaction among trainees and potential uncertainty regarding advancement decisions made by program leadership. The goal of this study was to assess the current quality of written feedback provided by pediatric hospital medicine (PHM) faculty within resident-end-of-rotation evaluation forms and describe faculty confidence, barriers, motivations, and experiences related to written feedback.

We conducted a single-center cross-sectional study of PHM faculty at a free-standing children's hospital from July to December 2023. We surveyed faculty to assess knowledge, skills, and attitudes related to written feedback. We also rated the quality of written feedback within a convenience sample of resident evaluations using the Evaluation of Feedback Captured Tool (EFeCT). High-quality written feedback was defined as an EFeCT score of 4 or 5.

Twenty of 24 (83%) eligible PHM faculty completed the survey. Time to reflect and write and competing work obligations were the largest barriers to providing high-quality feedback reported. Eighty percent (16/20) reported spending 15 minutes or less completing an individual evaluation. The overall mean EFeCT score was 4 out of 5 points (SD 1.4) for 66 evaluations, written by 9 participants. Action planning was present in 74% (49/66). Only 64% (42/66) described the context in which observed behaviors occurred. High-quality written feedback was possible to achieve in as little as 278 characters, or approximately 40 words; however, feedback containing more than 500 characters, or 80 to 100 words, more reliably achieved high quality.

Faculty understanding of context-based feedback and learner-specific action plans may represent content areas for faculty development sessions. Reframing faculty mindset around time spent writing feedback and maximizing the quality of feedback within required evaluations may be beneficial to combat the competing time constraints and work obligations faced by faculty.