Dataset Information

Evaluation of a tool to improve the quality of preceptor written feedback for family medicine residents: training and use of a CanMEDS-MF competency-based criterion guide.

ABSTRACT:

Background

Written feedback is essential in resident teaching, but preceptors are not always well equipped to provide relevant feedback. The purpose of this study was to evaluate the effectiveness of multi-episodic training and the use of a criterion-referenced guide for written feedback for family medicine preceptors in a French-language academic hospital.

Method

Twenty-three (23) preceptors participated in the training and used the criterion-referenced guide to guide them during the written evaluation in an evaluation sheet named "Field Notes." The content of these Field Notes was analyzed according to completion, the rate of specific feedback, and the rate of feedback by CanMEDS-MF role before and after the training over a three-month period.

Results

Based on the analysis of the Field Notes (n = 70 pre-test; n = 138 post-test), an increase in the percentage of completion (50% vs. 92%, z = 2.97, p = 0.0030) and specific feedback (59% vs. 92%, z = 2.47, p=0.0137) was noted. There was no significant increase in feedback by CanMEDS-MF role.

Conclusions

The development of multi-episodic training and a criterion-referenced guide, created according to the CanMEDS-MF repository, suggests an improvement in comprehensive and specific written feedback in family medicine education.

SUBMITTER: Desjardins C

PROVIDER: S-EPMC10042787 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Evaluation of a tool to improve the quality of preceptor written feedback for family medicine residents: training and use of a CanMEDS-MF competency-based criterion guide.

Desjardins Chloé C Pitre Lyne L Adjo David D Sagne Jean Henri JH Fotsing Salomon S Dionne Éric É Seale Edward E Pomerleau Marjorie M Philippe Marissa M Gharib Georges G Denis-LeBlanc Manon M

Canadian medical education journal 20230321 1

<h4>Background</h4>Written feedback is essential in resident teaching, but preceptors are not always well equipped to provide relevant feedback. The purpose of this study was to evaluate the effectiveness of multi-episodic training and the use of a criterion-referenced guide for written feedback for family medicine preceptors in a French-language academic hospital.<h4>Method</h4>Twenty-three (23) preceptors participated in the training and used the criterion-referenced guide to guide them during ...[more]

PMID: 36998496

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Project description:BackgroundIn 2013 the Accreditation Council for Graduate Medical Education (ACGME) introduced "Milestones" designed to nationally standardize the assessment of resident physicians. Previous studies compare resident self-assessment on milestones to faculty assessment, with varying degrees of agreement, but integration of self-assessment into the formative feedback process has not yet been directly studied. This study uses a conceptual framework of self-determination theory, integrated with concepts from adult learning theory, to compare the perception of the feedback quality given in semiannual reviews before and after the incorporation of resident self-assessment into the feedback process.MethodsThis was an interventional study conducted in a single emergency medicine residency program at a major academic hospital over 1 calendar year. Residents first engaged in a semiannual review without self-assessment. At subsequent semiannual reviews, residents completed a Milestone-based self-assessment that was provided to the faculty member assigned to conduct their semiannual review. Residents and faculty completed surveys rating perception of feedback quality. Two-sided Wilcoxon signed-rank tests were used in comparison analysis.ResultsOne resident did not self-assess prior to the semiannual review and was excluded leaving 25 paired surveys for analysis. Residents found feedback after the self-assessment more actionable (p = 0.013), insightful (p = 0.010), and better overall (p = 0.025). Similarly, faculty felt the feedback they provided was more actionable (p < 0.001), more insightful (p < 0.001), and better communicated (p < 0.001); led to improved resident understanding of milestones (p < 0.001); and were overall more satisfied (p < 0.001). Free-text comments explore pre- and postintervention perceptions of feedback.ConclusionsIntegration of self-assessment into semiannual reviews improves perception of feedback given to residents as perceived by both residents and faculty. Although limited by sample size, the results are promising for a simple, evidence-based intervention to improve feedback during an existing mandated feedback opportunity.

Project description:ImportanceGender disparities exist throughout medicine. Recent studies have highlighted an attainment gap between male and female residents in performance evaluations on Accreditation Council for Graduate Medical Education (ACGME) milestones. Because of difficulties in blinding evaluators to gender, it remains unclear whether these observed disparities are because of implicit bias or other causes.ObjectiveTo estimate the magnitude of implicit gender bias in assessments of procedural competency in emergency medicine residents and whether the gender of the evaluator is associated with identified implicit gender bias.Design, setting, and participantsA cross-sectional study was performed from 2018 to 2020 in which emergency medicine residency faculty assessed procedural competency by evaluating videos of residents performing 3 procedures in a simulated environment. They were blinded to the intent of the study. Proceduralists were filmed performing each procedure from 2 different viewpoints simultaneously by 2 different cameras. One was a gender-blinded (ie, hands-only) view, and the other a wide-angled gender-evident (ie, whole-body) view. The faculty evaluators viewed videos in a random order and assessed procedural competency on a global rating scale with extensive validity evidence for the evaluation of video-recorded procedural performance.Main outcomes and measuresThe primary outcome was to determine if there was a difference in the evaluation of procedural competency based on gender. The secondary outcome was to determine if there was a difference in the evaluations based on the gender of the evaluator.ResultsFifty-one faculty evaluators enrolled from 19 states, with 22 male participants (43.1%), 29 female participants (56.9%), and a mean (SD) age of 37 (6.4) years. Each evaluator assessed all 60 procedures: 30 gender-blinded (hands-only view) videos and 30 identical gender-evident (wide angle) videos. There were no statistically significant differences in the study evaluators' scores of the proceduralists based on their gender, and the gender of the evaluator was not associated with the difference in mean scores.Conclusions and relevanceIn this study, we did not identify a difference in the evaluation of procedural competency based upon the gender of the resident proceduralist or the gender of the faculty evaluator.

Project description:ObjectivesResidents in emergency medicine have reported dissatisfaction with feedback. One strategy to improve feedback is to enhance learners' feedback literacy-i.e., capabilities as seekers, processors, and users of performance information. To do this, however, the context in which feedback occurs needs to be understood. We investigated how residents typically engage with feedback in an emergency department, along with the potential opportunities to improve feedback engagement in this context. We used this information to develop a program to improve learners' feedback literacy in context and traced the reported translation to practice.MethodsWe conducted a year-long design-based research study informed by agentic feedback principles. Over five cycles in 2019, we interviewed residents and iteratively developed a feedback literacy program. Sixty-six residents participated and data collected included qualitative evaluation surveys (n = 55), educator-written reflections (n = 5), and semistructured interviews with residents (n = 21). Qualitative data were analyzed using framework analysis.ResultsWhen adopting an agentic stance, residents reported changes to the frequency and tenor of their feedback conversations, rendering the interactions more helpful. Despite reporting overall shifts in their conceptions of feedback, they needed to adjust their feedback engagement depending on changing contextual factors such as workload. These microsocial adjustments suggest their feedback literacy develops through an interdependent process of individual intention for feedback engagement-informed by an agentic stance-and dynamic adjustment in response to the environment.ConclusionsResident feedback literacy is profoundly contextualized, so developing feedback literacy in emergency contexts is more nuanced than previously reported. While feedback literacy can be supported through targeted education, our findings raise questions for understanding how emergency medicine environments afford and constrain learner feedback engagement. Our findings also challenge the extent to which this contextual feedback know-how can be "developed" purposefully outside of the everyday work.

Dataset Information

Evaluation of a tool to improve the quality of preceptor written feedback for family medicine residents: training and use of a CanMEDS-MF competency-based criterion guide.

Background

Method

Results

Conclusions

Publications

Evaluation of a tool to improve the quality of preceptor written feedback for family medicine residents: training and use of a CanMEDS-MF competency-based criterion guide.

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