For single-source feedback, including the mean and percentile rank on feedback by nursing staff does not improve physician-nurse communication amongst anesthesiologists as compared to the raw score alone

ABSTRACT

Background: Audit and feedback has increasingly become part of the medical professional landscape as a means to improve quality of practice. While many performance evaluation tools exist, there remains a paucity of research that assesses the relative effectiveness of the various components of assessment and feedback. Using a single-source framework, we investigated the value of a percentile rank score as a feedback tool to promote individual improvement.

Method: Ninety peri-operative nurses completed an initial survey assessing the communication skills of 30 anesthesiologists at London Health Sciences Centre using a five-point Likert scale. Physicians were randomized to receive either only their score, or their score compared to the mean along with their percentile rank. An identical survey asking peri-operative nurses to re-evaluate each anesthesiologist’s communication skills was sent 3 months later, yielding 76 responses.

Results: Regardless of whether or not anesthesiologists received feedback that contained individual scores only or individual scores along with the group mean and percentile rank, there was no significant impact on perceived communication from peri-operative nurses.

Conclusions: A percentile rank score was an ineffective component within single-source assessment and feedback to improve peri-operative communication.

KEYWORDS:

• Feedback
• healthcare communication
• peri-operative
• physician-nurse communication
• anesthesiologist
• medical education
• interprofessional communication
• quality improvement

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Dr Collin Clarke is an Assistant Professor in the Department of Anesthesia and Perioperative Medicine at Western University. After completing residency at Western University, he completed an Interventional Pain Management Fellowship at Duke University Medical Center in North Carolina. During his fellowship, he focused primarily on the management of Complex Regional Pain as well as fluoroscopically guided interventions for the management of spinal mediated pain syndromes. In addition to peri-operative anesthesia, Dr Clarke works in pain medicine. His practice has a special focus on chronic regional pain and fluoroscopically guided interventional procedures for spinal mediated pain syndromes. His research interests focus on functional imaging for the interpretation of pain pathways, as well as medical education.

Dr Bradley Rostas is a resident with the Department of Emergency Medicine at Western University in London, Ontario.

Dr. George Nicolaou completed Medical School at the University of Witwatersrand, Johannesburg, South Africa and an Anesthesiology Residency Program at the University of Manitoba, Winnipeg, MB. He followed this with a Clinical and Research Fellowship in Thoracic and Vascular Anesthesia with Acute Pain Management at Western University and then started working at London Health Sciences Centre and St. Joseph’s Health Care. He is currently the Director and Fellowship/Resident Coordinator of Thoracic and Vascular Anesthesia at London Health Sciences Centre.

ORCID

Collin Clarke http://orcid.org/0000-0003-3677-5900

Bradley Rostas http://orcid.org/0000-0001-8322-6571