Encouraging residents to seek feedback

Dianne DelvaDepartment of Family and Community Medicine, University of Toronto, ON, Canada; DIANNE DELVA, MD, is a Professor of Family Medicine and was an Associate Dean of Undergraduate Medical Education.Correspondence[email protected]

Joan SargeantDivision of Medical Education, Dalhousie University, Halifax, NS, Canada; JOAN SARGEANT, PhD, is a professor and acting director of the Division of Medical Education at Dalhousie University.

Stephen MillerDivision of Medical Education, Dalhousie University, Halifax, NS, Canada;Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada; STEPHEN MILLER, MD, is an assistant professor of Emergency Medicine, and the Division of Medical Education Dalhousie University.

Joanna HollandDepartment of Pediatrics, Dalhousie University, Halifax, NS, Canada; JOANNA HOLLAND, MD, is an assistant Professor of Pediatrics at Dalhousie University.

Peggy Alexiadis BrownDivision of Medical Education, Dalhousie Medicine New Brunswick, Saint John, NB, Canada; PEGGY ALEXIADIS BROWN, MA, is a Program Evaluation Specialist for the Division of Medical Education, Dalhousie Medicine New Brunswick, Saint John, New Brunswick.

Constance LeblancDivision of Medical Education, Dalhousie University, Halifax, NS, Canada;Department of Pediatrics, Dalhousie University, Halifax, NS, Canada;Continuing Medical Education, Dalhousie University, Halifax, NS, Canada; CONSTANCE LEBLANC, MD, MAEd, is an Associate Dean for Continuing Medical Education and Professor of Emergency Medicine at Dalhousie University.

Kathryn LightfootContinuing Medical Education, Dalhousie University, Halifax, NS, Canada; KATHRYN LIGHTFOOT, MA, is a Research Associate in Continuing Medical Education, Dalhousie University.

Karen MannDivision of Medical Education, Dalhousie University, Halifax, NS, Canada; KAREN MANN, PhD, is a Professor Emeritus, Division of Medical Education, Dalhousie University.

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Abstract

Aim: To explore resident and faculty perceptions of the feedback process, especially residents’ feedback-seeking activities.

Methods: We conducted focus groups of faculty and residents exploring experiences in giving and receiving feedback, feedback-seeking, and suggestions to support feedback-seeking. Using qualitative methods and an iterative process, all authors analyzed the transcribed audiotapes to identify and confirm themes.

Results: Emerging themes fit a framework situating resident feedback-seeking as dependent on four central factors: (1) learning/workplace culture, (2) relationships, (3) purpose/quality of feedback, (4) emotional responses to feedback. Residents and faculty agreed on many supports and barriers to feedback-seeking. Strengthening the workplace/learning culture through longitudinal experiences, use of feedback forms and explicit expectations for residents to seek feedback, coupled with providing a sense of safety and adequate time for observation and providing feedback were suggested. Tensions between faculty and resident perceptions regarding feedback-seeking related to fear of being found deficient, the emotional costs related to corrective feedback and perceptions that completing clinical work is more valued than learning.

Conclusion: Resident feedback-seeking is influenced by multiple factors requiring attention to both faculty and learner roles. Further study of specific influences and strategies to mitigate the tensions will inform how best to support residents in seeking feedback.

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