P092: Clinical performance feedback to paramedics: what they receive and what they need

Abstract

Introduction: Clinical performance feedback is not always well utilized in healthcare, despite its potential in continual professional development to improve provider performance in healthcare settings. In order to more effectively incorporate performance feedback, we must evaluate the strengths and flaws of current feedback systems and determine best practices. With this goal, we sought to explore the perspectives of paramedics on the feedback they want and what they currently receive. Methods: We used a qualitative methodology with semi-structured interviews. A convenience sampling of practicing paramedics in the Niagara region was interviewed. We used an interpretive descriptive technique with continuous recruitment of participants until thematic saturation was achieved. Themes were identified and a coding system was developed by two investigators separately to code themes and sub-themes. These two systems were merged by consensus. We conducted a member check by contacting participants to determine if they agreed with our analysis. Results: 12 paramedics were interviewed. In our analysis we found several themes: positive perception/aspects of feedback and current feedback systems, current barriers, shortcomings of current systems, desire to know patient outcomes, and mental health as it relates to feedback. Positive perception of feedback has included asking for feedback, specific requests for feedback and strengths of current systems. Perceived barriers to feedback included issues around: confidentiality, practical limitations and social barriers. The limitations of current feedback systems noted the lack of feedback, and the questionable value of the feedback received. The desire to know patients’ clinical course/outcomes was also a recurrent theme, with paramedics spontaneously expressing desire for feedback specific to cases, greater insight into the ultimate diagnosis and knowledge of outcomes. The mental health of paramedics was frequently discussed as well, including positive impact on job satisfaction and confidence and potential for negative impact. Conclusion: We have explored and generated a description of the perspectives of paramedics on feedback in general and the clinical performance feedback they currently receive. The information gained will lay the groundwork for improved feedback systems to provide paramedics with the feedback they want to continually improve as healthcare providers.