Resident identification of feedback and teaching on rounds

Abstract

Feedback and teaching occur regularly on teaching hospital wards. Although feedback has important implications for resident learning, residents often report that they receive little feedback. The significant overlap of teaching and feedback in clinical education may contribute to resident difficulty with feedback identification. We sent a survey with seven scenarios to internal medicine residents across the country. Two of the scenarios contained teaching, two contained feedback, and three contained combined teaching and feedback. From October 2017 to April 2018, 17% of residents (392/2346) from 17 residency programs completed the survey. Participating residents correctly identified both feedback scenarios 89% of the time, both teaching scenarios 64% of the time, and all three combined teaching and feedback scenarios 38% of the time. Interns were less likely than upper-level residents to correctly identify combined teaching and feedback scenarios (P ¼ 0.005). Residents may have difficulty identifying feedback in the context of teaching. This confusion may contribute to residents' perceptions that they receive little feedback.

Medical residents and attending physicians’ perceptions of feedback and teaching in the United States: a qualitative study

“…Previous work showed that residents have difficulty identifying and differentiating feedback and teaching in the clinical setting [ 7 ]. This analysis demonstrates one possible reason for this difficulty is that feedback and teaching are ubiquitous in the clinical learning environment, creating confusion in their distinction.…”

“…To explore why residents might have difficulty recognizing feedback when it occurs with teaching, these questions were followed by an exercise asking participants to compare 2 scenarios. The scenarios were identified by residents and faculty in our prior study as one of stand-alone teaching and a second of both feedback and teaching [ 7 ]. Focus groups were not repeated.…”

“…Although residents and faculty agree on the importance of feedback [ 5 , 6 ], they often disagree on the frequency of feedback in clinical scenarios [ 7 ]. We previously conducted a national survey of internal medicine residents demonstrating that residents may have difficulty identifying feedback in the context of teaching [ 7 ].…”

“…Although residents and faculty agree on the importance of feedback [ 5 , 6 ], they often disagree on the frequency of feedback in clinical scenarios [ 7 ]. We previously conducted a national survey of internal medicine residents demonstrating that residents may have difficulty identifying feedback in the context of teaching [ 7 ]. Whereas feedback provides information related to a learner’s performance intended to improve future work [ 2 ], teaching relates to providing information to learners based on an identified gap or need [ 8 ].…”

Evaluating the SPIKES Model for Improving Peer-to-Peer Feedback Among Internal Medicine Residents: a Randomized Controlled Trial

“…Additionally, residents frequently confuse teaching and feedback or fail to recognize when educators are providing feedback. 28 The SPIKES framework incorporates an invitation to provide feedback which could indicate to learners that feedback is occurring when they otherwise would not recognize it.…”