Background: Effective feedback is essential for learners to develop skills needed to provide quality patient care and to work productively on teams. Hospitalists supervising students and residents are an important source of feedback, yet must balance teaching with the demands of direct patient care and other non-clinical obligations. 84% of 812 hospitalists in a national sample identified barriers to providing feedback including lack of skills or confidence, hesitancy in giving “negative” feedback, and lack of time. Successful feedback delivery requires attention to the content of the feedback, the learner’s affective state and receptiveness, and the cultural milieu of the educational environment. Empowering hospitalists with skills and knowledge to provide high-quality feedback has the potential to improve resident clinical performance and learning and increase hospitalists’ professional satisfaction.
Purpose: We sought to develop and deliver educational programming on providing feedback to hospitalist faculty at an academic medical center. Our goals were to improve the confidence and comfort level of faculty in providing feedback and to improve resident evaluations of faculty feedback quality.
Description: We convened a project team comprised of a medical education scholar, a general internist with expertise in medical education and faculty development, and two hospitalists with key roles in clinical education. We performed a needs assessment including literature review, review of program survey results, analysis of aggregate faculty evaluation data, and interviews with residents and faculty. Based on this assessment, we developed a two part workshop adapting the SMART (Specific, Measurable, Achievable, Realistic, Timely) mnemonic for goal setting as a model for giving feedback. In the first 45 minute session (workshop A) faculty learned the SMART feedback tool and practiced giving feedback by role playing realistic feedback scenarios in small groups. The second session (workshop B) focused on strategies to recognize and provide feedback in scenarios in which the learner’s emotions or cognitive state made providing feedback more challenging. We delivered each workshop twice to allow flexible scheduling for hospital medicine faculty to attend one session of each workshop. A total of 18 faculty participated in workshop A and 11 in workshop B. There was a trend toward increased self-assessed knowledge and confidence in providing feedback among participants who completed a brief survey before and after each session (see figures 1 and 2). Aggregate evaluation scores of the quality of feedback by faculty as assessed by residents on ward rotations was not statistically different in the 4 month period following the first workshop compared to baseline, however the analysis is limited by temporal factors and insufficient power; assessment of this outcome over a longer time period is ongoing.
Conclusions: This two part workshop incorporates an easy to recall, outcomes oriented mnemonic and attention to learner factors relevant to effective feedback conversations. The workshop could be integrated into a division meeting or educational conference to provide knowledge and skills development targeted to faculty who teach in hospital medicine settings. Faculty participating in the workshops increased their self-assessed knowledge and confidence in providing feedback.