From Talk to Text: Improving Feedback Concordance With a Simple Intervention

High-quality written feedback is critical to learner development. Actionable feedback is essential in emergency medicine (EM), where students do not consistently rotate with the same supervisor. Medical students frequently report dissatisfaction with feedback due to inadequate quantity, vagueness, and discordance between verbal and written elements. Educational scripts, sometimes referred to as "scaffolds", prompt people to respond in a desired manner and show potential as an intervention to encourage clinical feedback.

We incorporated a "stop and think" verification question in medical student assessments. Supervisors answered yes or no to the statement: "I discussed this feedback with the student." We hypothesized this would improve students' assessment of feedback quality and verbal-written feedback concordance. Outcomes include three feedback perception questions added to the end-of-clerkship student evaluations and qualitative analysis of the types of narrative feedback provided. We prospectively collected 8 months of assessment data (n = 82) and compared pre-intervention data to 5 months of post-intervention data (n = 49) for length and content.

The percentage of students rating the quality of clerkship feedback as excellent or very good remained stable (62% vs. 74%, p 0.76). Students reporting concordance of the verbal and written feedback the majority of the time improved significantly from 72% to 87% (p < 0.001). Importantly, the proportion of students reporting feedback concordance more than 75% of the time increased from 37% to 67%. The content and type of written feedback did not change. The intervention did not change assessment response rate for supervisors or learners (36% vs. 36%; 74% vs. 72%, respectively).

A verification question added to student assessment forms can positively impact student perceptions of verbal-written feedback concordance without altering the content of feedback provided, including actionability. This easy-to-implement strategy provides one mechanism to encourage supervisors to provide more feedback to trainees.