Does questionnaire-based patient feedback reflect the important qualities of clinical consultations? Context, benefits and risks

Burford, Bryan; Greco, Michael; Bedi, Ajay; Kergon, Charlotte; Morrow, Gill; Livingston, Moira; Illing, Jan

doi:10.1016/j.pec.2010.07.044

Cited by 9 publications

(9 citation statements)

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“…Whilst gathering patient feedback maybe an acceptable and appropriate way of evaluating the practitioner's communication skills, doctors have reported finding it stressful, and indicated they may target specific patients or sessions or they may even alter their behaviour in the knowledge that feedback is being sought. 15 In our research this may also have been influenced by each practitioners' enthusiasm for or belief in the process, concerns or fears associated with the collection of feedback and engagement or their general willingness and ability to comply with prescribed tasks. In this study, although the number of forms collected per student was not attributed, the distribution of cards was initiated by the supervising clinician, so this effect would be minimised.…”

Section: Discussionmentioning

confidence: 87%

Just One Thing: a novel patient feedback model

et al. 2017

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In response to the Educational Standards of the UK's General Dental Council, Newcastle University, School of Dental Sciences introduced a patient feedback card to gather and incorporate patient feedback into their undergraduate assessment framework. The cards ask for patient response to two questions about their experience, and also ask patients to identify 'Just One Thing' (JOT) the student could do to improve this. JOT cards completed during a two week period were collected to evaluate and analyse the nature of patient responses within this model. Over 90% of JOT cards scored the students as 'Excellent' with the remainder scoring the student as 'Good' or giving no response. Many of the free text comments complimented the students and also provided focused suggestions for improvement. While the overwhelming positive responses may suggest that this model for collecting feedback may not be effective at discriminating between students with varying levels of interpersonal/communication skills, the free text comments were seen to be of value in building confidence or identifying areas for improvement.

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Section: Discussionmentioning

confidence: 87%

Just One Thing: a novel patient feedback model

et al. 2017

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“…Included studies reported: a change in organisational practice ( n =1, Kirkpatrick level 4a) [ 7 ]; a measured change in behaviour ( n =6, Kirkpatrick level 3b) [ 13 , 50 – 54 ]; self-reported change or intention to change ( n =12, Kirkpatrick level 3a), [ 2 , 8 , 10 , 11 , 17 , 55 – 61 ] and acquisition of knowledge or skills ( n =1, Kirkpatrick level 2b) following the provision of patient feedback [ 1 ]. No studies identified a change at the highest evaluation level – a change in the health and wellbeing of patients (Kirkpatrick level 4b).…”

Section: Resultsmentioning

confidence: 99%

“…One study identified a change in knowledge acquisition/understanding [ 1 ]. Doctors involved in this study reported learning about the importance of trust, consultation style and communication [ 1 ].…”

Section: Resultsmentioning

confidence: 99%

“…Finally, while all 20 studies reported a change in medical performance to some degree, 13 identified specific changes in behaviour. Communication was the most frequently targeted area for improvement [ 1 , 7 , 13 , 50 – 54 , 60 , 61 ]. Few identified initiatives targeting clinical competence, care coordination [ 51 ], or access to healthcare services [ 7 , 52 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patient feedback is considered integral to quality improvement and professional development [ 1 – 3 ]. Designed to guide behaviour change and facilitate reflective practice [ 4 ], patient feedback is increasingly incorporated into medical education including continuing professional development and regulatory initiatives such as medical revalidation [ 5 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

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The impact of patient feedback on the medical performance of qualified doctors: a systematic review

et al. 2018

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BackgroundPatient feedback is considered integral to quality improvement and professional development. However, while popular across the educational continuum, evidence to support its efficacy in facilitating positive behaviour change in a postgraduate setting remains unclear. This review therefore aims to explore the evidence that supports, or refutes, the impact of patient feedback on the medical performance of qualified doctors.MethodsElectronic databases PubMed, EMBASE, Medline and PsycINFO were systematically searched for studies assessing the impact of patient feedback on medical performance published in the English language between 2006-2016. Impact was defined as a measured change in behaviour using Barr’s (2000) adaptation of Kirkpatrick’s four level evaluation model. Papers were quality appraised, thematically analysed and synthesised using a narrative approach.ResultsFrom 1,269 initial studies, 20 articles were included (qualitative (n=8); observational (n=6); systematic review (n=3); mixed methodology (n=1); randomised control trial (n=1); and longitudinal (n=1) design). One article identified change at an organisational level (Kirkpatrick level 4); six reported a measured change in behaviour (Kirkpatrick level 3b); 12 identified self-reported change or intention to change (Kirkpatrick level 3a), and one identified knowledge or skill acquisition (Kirkpatrick level 2). No study identified a change at the highest level, an improvement in the health and wellbeing of patients. The main factors found to influence the impact of patient feedback were: specificity; perceived credibility; congruence with physician self-perceptions and performance expectations; presence of facilitation and reflection; and inclusion of narrative comments. The quality of feedback facilitation and local professional cultures also appeared integral to positive behaviour change.ConclusionPatient feedback can have an impact on medical performance. However, actionable change is influenced by several contextual factors and cannot simply be guaranteed. Patient feedback is likely to be more influential if it is specific, collected through credible methods and contains narrative information. Data obtained should be fed back in a way that facilitates reflective discussion and encourages the formulation of actionable behaviour change. A supportive cultural understanding of patient feedback and its intended purpose is also essential for its effective use.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1277-0) contains supplementary material, which is available to authorized users.

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Measuring patient-provider communication skills in Rwanda: Selection, adaptation and assessment of psychometric properties of the Communication Assessment Tool

Cubaka

Schriver

Vedsted

et al. 2018

Patient Education and Counseling

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Does questionnaire-based patient feedback reflect the important qualities of clinical consultations? Context, benefits and risks

Abstract: Doctors should consider the transactional or relational preference of a patient in approaching a consultation. Patient feedback can deliver benefits to doctors and patients, but risks must be acknowledged and mitigated against.

Cited by 9 publications

References 75 publications

Just One Thing: a novel patient feedback model

Just One Thing: a novel patient feedback model

The impact of patient feedback on the medical performance of qualified doctors: a systematic review

Measuring patient-provider communication skills in Rwanda: Selection, adaptation and assessment of psychometric properties of the Communication Assessment Tool

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