Challenges of feedback provision in the workplace: A qualitative study of emergency medicine residents and teachers

Abstract

Background: Feedback is an effective pedagogical tool in clinical teaching and learning, but is often perceived as unsatisfactory. Little is known about the effect of a busy clinical environment on feedback-giving and -seeking behaviors. This study aims to determine the perceptions and challenges of feedback provision in a busy clinical setting, exemplified by an emergency department (ED).

Methods: A qualitative semi-structured interview study design was employed. Thirty-six participants (18 attending physicians, 18 residents) were purposively sampled from three EDs in northern Taiwan between August 2015 and July 2016. Interviews were recorded, transcribed, and analyzed thematically.

Results: Three major themes were identified with illustrative quotes: (1) the balance between patient safety and providing feedback, (2) variability in feedback, and (3) influential factors, barriers and enablers.

Conclusions: In real practice, clinical duties competed with the impulse to provide feedback. The variety and complexity of feedback extended beyond style and content. Clinical and contextual factors – some of which may be presented as barriers – influenced how, when and whether a teacher or learner decided to give or seek feedback.

Acknowledgements

The authors wish to thank Dr. Koshila Kumar of Flinders University, Australia, for her generous advice regarding the research method and analysis.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

This research was funded by Chang-Gung Research Grant CDRPG3E0081 and Ministry of Science and Technology (MOST) grant MOST 105-2511-S-182-016.

Glossary

Feedback: Specific information about the comparison between a trainee's observed performance and a standard, given with the intent to improve the trainee's performance.

van de Ridder, J.M., Stokking, K.M., McGaghie, W.C., & ten Cate, O.T. (2008) What is feedback in clinical education? Medical Education. 42(2):189-97

Notes on contributors

Chung-Hsien Chaou, MD, PhD, is an emergency faculty and Assistant Professor in Chang-Gung Memorial Hospital, Linkou branch, and a physician educator in Chang-Gung Medical Education Research Center, Taoyuan, Taiwan.

Lynn V. Monrouxe, PhD, is the director of Chang-Gung Medical Education Research Center, Taoyuan, Taiwan.

Li-Chun Chang, PhD, is a professor in department of nursing, Chang-Gung University of Science and Technology, Taoyuan, Taiwan.

Shiuan-Ruey Yu, BS, is a researcher with nursing and qualitative research background in Chang-Gung Medical Education Research Center, Taoyuan, Taiwan.

Chip-Jin Ng, MD, MSc., is the chief of department of emergency medicine and Assistant Professor in Chang-Gung Memorial Hospital, Linkou branch.

Ching-Hsing Lee, MD, is an emergency faculty and Assistant Professor in Chang-Gung Memorial Hospital, Keelung branch.

Yu-Che Chang, MD, is an emergency faculty and Assistant Professor in Chang-Gung Memorial Hospital, Linkou branch, and a physician educator in Chang-Gung Medical Education Research Center, Taoyuan, Taiwan.

Additional information

Funding

Ministry of Science and Technology10.13039/501100006280CDRPG3E0081MOST 105-2511-S-182-016

Chang Gung Memorial Hospital, Linkou10.13039/501100005795CDRPG3E0081