A Targeted Feedback Framework to Move the Needle on Operative Feedback

IF 2.6 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2025-01-17 DOI:10.1016/j.jsurg.2024.103414

Christine Wu MD MMSc , Douglas S. Smink MD MPH , Gurjit Sandhu PhD , Erik K. Alexander MD , Stephanie L. Nitzschke MD

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引用次数: 0

Abstract

Objective

Actionable and impactful feedback remains a perpetual challenge in medical education despite extensive efforts to improve the feedback process. A feedback framework was adapted from a validated model and tailored to a single residency program. The purpose of this study was to evaluate the impact of the new feedback framework on the quantity and quality of perioperative feedback amongst surgical residents.

Design

A nonrandomized interventional study was conducted in a general surgery residency program at a single academic institution over a 6-month study period. The new ‘Brainstorm’, ‘Focus’, and ‘Recap’ (BFR) feedback framework was introduced to surgical faculty and residents on 2 surgical services. Posters of the framework were displayed in the operating rooms and scrub sinks. Regular reminder emails were sent, and competitions were held to encourage engagement. Pre and postintervention surveys were distributed electronically to all participants.

Setting

Brigham and Women's Hospital Department of Surgery in Boston, MA.

Participants

A total of 19 faculty and 56 residents inclusive of 2 general surgery services (trauma and acute care surgery; minimally invasive and bariatric surgery).

Results

Faculty reported giving more frequent and higher quality feedback than residents reported receiving, before and after the intervention. There was increased satisfaction with technical feedback following the intervention, which was reported by both faculty (27.3%-73.3%, p = 0.01) and upper-level residents (17.7%-54.6%, p = 0.02). Faculty and residents mutually indicated improved overall feedback breadth (faculty 58.2%-78.7%, p = 0.01; residents 41.6%-54.3%, p = 0.03).

Conclusions

The introduction of a tailor-made framework that utilizes a structured, shared mental model to promote goal-oriented feedback improved faculty and resident practices and perceptions of perioperative feedback. Nevertheless, a disparity between faculty and resident perceptions persists. More work is needed to overcome the complexities of the surgical learning environment and better align faculty and resident perceptions.

查看原文本刊更多论文

一个有针对性的反馈框架来推动手术反馈。

目标：尽管为改进反馈过程作出了广泛的努力，但可操作和有效的反馈仍然是医学教育中一个永恒的挑战。反馈框架是从一个经过验证的模型中改编而来的，并为单个住院医师项目量身定制。本研究的目的是评估新的反馈框架对外科住院医师围手术期反馈的数量和质量的影响。设计：在一所学术机构的普通外科住院医师项目中进行了一项为期6个月的非随机介入研究。新的“头脑风暴”、“焦点”和“回顾”（BFR）反馈框架被引入到外科医生和住院医生的2个外科服务中。该框架的海报张贴在手术室和擦洗池。定期发送提醒邮件，并举办竞赛以鼓励参与。干预前和干预后的调查以电子方式分发给所有参与者。地点：马萨诸塞州波士顿布里格姆妇女医院外科。参与者：共有19名教师和56名住院医生，包括2个普通外科部门(创伤和急性护理外科；微创和减肥手术)。结果：在干预前后，教师报告的反馈比住院医生报告的反馈更频繁，质量更高。干预后对技术反馈的满意度有所提高，教师（27.3% ~ 73.3%,p = 0.01）和上层居民（17.7% ~ 54.6%,p = 0.02）均有报告。教师和住院医师均表示总体反馈广度有所提高(教师58.2% ~ 78.7%,p = 0.01；居民41.6% ~ 54.3%,p = 0.03)。结论：引入一个量身定制的框架，利用一个结构化的、共享的心理模型来促进目标导向的反馈，改善了教师和住院医生的实践和对围手术期反馈的认识。然而，教师和居民之间的看法仍然存在差异。需要做更多的工作来克服外科学习环境的复杂性，并更好地协调教师和住院医生的看法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.