G. Shaughness1, P. Georgoff1, G. Sandhu1, L. Leininger1, R. Reddy1, D. T. Hughes1 1University Of Michigan,Ann Arbor, MI, USA
Introduction: Clinical rotations in the third and fourth years of medical school mark a shift in learning methodology from structured didactics to bedside apprenticeship. In this setting, feedback, which is traditionally verbal and not formally recorded, plays a critical role in student development. Little is known about the quantity and quality of feedback provided. This study uses a novel, web-based Minute Feedback System to evaluate feedback given to students during their core surgical clerkship.
Methods: Content of feedback, student request rates, and resident and faculty response rates obtained from the Minute Feedback System between May 2015 and April 2016 were analyzed. Four categories were assigned to qualify feedback students received: “encouraging” praises a student’s performance, “corrective” highlights areas for improvement, “general” characterizes vague comments, and “specific” identifies concrete skills. These were then grouped by quality: “good” feedback comprised any combination of specific and either corrective or encouraging; “mediocre” included all categories without differentiation; “bad” feedback was defined as general combined with either encouraging or corrective. Responses were attributed to surgery residents of differing training levels and to faculty members, which were analyzed as a whole and separately. Significant differences between groups was determined with Chi Square with p <0.05 considered significant.
Results: During the study period there were 3191 unique feedback requests. The overall response rate was 62%. The faculty response rate was 66%, senior residents (PGY 3-7) 59%, and junior residents (PGY 1-2) 60%. Separated by respondents, general feedback was given by 60% of faculty, 72% of senior residents, and 68% of junior residents; the difference between groups was not significant. Specific feedback was given by 16% of faculty, 8% of senior residents, and 17% of junior residents (p < 0.05 between faculty and all residents). Faculty provided “good” feedback 16% of the time, compared to 8% of senior resident feedback and 17% of junior resident feedback (p < 0.05 between faculty and senior residents). “Mediocre” feedback from faculty was 13% of comments while 9% of senior resident and 7% of junior resident feedback met the same criteria (p <0.05 between all groups). “Bad” feedback comprised 67% of total feedback, including 60% of faculty feedback, 72% of senior resident feedback, and 68% of junior resident feedback (p < 0.05 between all groups).
Conclusion: Using a novel, web-based feedback system we found the majority of feedback provided to medical students during their core surgery clerkship was poor quality, consisting primarily of general and encouraging comments. This represents an opportunity for system development and surgeon education regarding optimal feedback techniques.