Feedback as a means to improve clinical competencies: Consultants’ perceptions of the quality of feedback given to registrars

Abstract

Background. Effective supervision by consultants in postgraduate medical education involves the process of feedback. Giving feedback may be challenging for consultants who have no formal training in this process, which may be further compounded in heterogeneous diverse settings. Objective. To explore consultants' perceptions of feedback to registrars in a multicultural, multilingual diverse academic hospital setting. Methods. Thirty-seven consultants consented to completing a questionnaire on what, when, where, how often, and how feedback was provided, as well as on the type and effect of feedback to registrars. Descriptive statistics were used to analyse the data. Differences between groups were calculated using Pearson's χ² test for independent variables, with a p-value of <0.05 regarded as being statistically significant. Results. Only 40% of consultants reported that they provided feedback often or always and 62.2% reported that standards were not predetermined and communicated to registrars. When feedback was provided, it was based on concrete observations of performance (78.4%), it incorporated a plan for improvement (72.9%) and it supplied information on techniques performed incorrectly (72.9%). Only 40.5% of consultants provided feedback on procedures performed correctly. Moreover, only half of the consultants believed they were proficient at giving feedback. Conclusion. Consultants need to develop the art of giving feedback through appropriate training so that they are more comfortable and proficient with the various aspects of feedback, leading to a positive effect on enhancing registrar training.

Effects of demographic factors on provision of feedback in postgraduate medical education

“…This belief was borne out by the findings that only just over a third of the consultants communicated in advance the desired standards of performance to be obtained and only about 40% gave feedback always or often (Bagwandeen and Singaram 2016a). More importantly, these studies found that the registrars believed that the feedback provided was influenced by their race, gender and ethnicity.…”

Anaesthesiology trainers’ knowledge, attitudes and practices of feedback in a South African anaesthesiology department

“…Implementing such initiatives with frequent feedback sessions based on pre-determined objectives and a plan for improvement may promote and enhance the feedback culture within anaesthesiology. 1,14,15,25 Our study found that, whilst all consultants provide feedback, very few acknowledged the continuous ongoing nature of feedback and many were unsure if the time spent with the trainee was adequate. Trainers reported often working with a different trainee in theatre and that trainees were exposed to a pool of consultants rather than an individual.…”

“…Similar to previous studies, we found that almost half of the trainers admitted to having difficulty giving negative feedback, as they felt the trainee may react negatively. 14 This is a major barrier to feedback, which leads to missed opportunities for the trainee to recognise underperformance and improve. Unchecked, a trainee may pass through a specialty over-confident without realising their shortcomings.…”

“…13 In two South African studies of six clinical and surgical disciplines (excluding anaesthetics), differences were reported between the trainees' and trainers' perceptions concerning feedback given. 14,15 Trainees felt that the quality of feedback provided by the trainers was poor, it was not provided often enough, and it was not always based on direct observations. 14 The trainers agreed that feedback was not provided often enough but differed in opinion on the quality and effectiveness of the feedback provided.…”

“…14,15 Trainees felt that the quality of feedback provided by the trainers was poor, it was not provided often enough, and it was not always based on direct observations. 14 The trainers agreed that feedback was not provided often enough but differed in opinion on the quality and effectiveness of the feedback provided. 15 To enhance feedback culture in the discipline of anaesthesiology, it is essential to evaluate the feedback perceptions of clinical trainers, as effective feedback allows learners to acquire new skills, knowledge and attitudes.…”