Feedback Culture Perceived by Trainees in an Academic Institution: A Mixed Methods Study.

Autor:	Phatak UP; Yale School of Medicine.; Department of Pediatrics.; Pediatric Gastroenterology, Hepatology and Nutrition., Encandela J; Yale School of Medicine.; Yale Teaching and Learning Center, School of Medicine, Yale University, New Haven, Connecticut., Green M; Yale School of Medicine.; Yale Teaching and Learning Center, School of Medicine, Yale University, New Haven, Connecticut.; Divisions of General Medicine, Department of Internal Medicine., Slade M; Yale School of Medicine.; Yale Teaching and Learning Center, School of Medicine, Yale University, New Haven, Connecticut., Osborn R; Yale School of Medicine.; Department of Pediatrics.; Hospital Medicine., Weiss P; Yale School of Medicine.; Department of Pediatrics.; Pulmonology, Allergy, Immunology, and Sleep Medicine.
Jazyk:	angličtina
Zdroj:	Hospital pediatrics [Hosp Pediatr] 2023 Nov 01; Vol. 13 (11), pp. 984-991.
DOI:	10.1542/hpeds.2022-007004
Abstrakt:	Objectives: Lack of a well-functioning institutional feedback culture can undermine acquisition of skills essential for high quality patient care. The objective of this study was to assess feedback culture perceived by resident and fellow trainees, utilizing a mixed methods design. Methods: Pediatric fellows and residents completed an anonymous feedback environment survey consisting of 7 constructs: source credibility, feedback quality, feedback delivery, reinforcing feedback, constructive feedback, source availability, and promotion of feedback seeking, using a 7-point Likert scale. Trainee ratings were compared using two-sided Fisher's exact tests. Multivariable analyses used a linear regression model. For the qualitative study, semistructured interviews of residents were conducted. The constant comparative method was used to incrementally code, categorize data, and derive themes. Results: Fifty-two residents and 21 fellows completed the survey (response rates 65% and 47%, respectively). Scores were more favorable for fellows compared with residents in 6 of 7 feedback constructs (P < .05), including on multivariate analysis. Hispanic ethnicity and female gender were associated with lower scores on source credibility (P = .04) and constructive feedback (P = .03), respectively. Two qualitative themes were identified: expectation of efficiency in patient care compromises the quality and quantity of feedback, and a culture that prioritizes courtesy over candor negatively impacts feedback quality. These themes were more pronounced when residents worked with pediatric subspecialists compared with hospitalists. Conclusions: We described the feedback culture, which was less favorable in the residency program. The need for efficient patient care and a culture of courtesy adversely impacted the quality of feedback, especially among subspecialists. (Copyright © 2023 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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