来源重要吗？护士和医生对跨专业反馈的看法。

Does source matter? Nurses' and Physicians' perceptions of interprofessional feedback.

作者信息

van Schaik Sandrijn M, O'Sullivan Patricia S, Eva Kevin W, Irby David M, Regehr Glenn

机构信息

Division of Pediatric Critical Care Medicine, University of California San Francisco, San Francisco, California, USA.

Office of Medical Education and Department of Medicine, University of California, San Francisco, California, USA.

出版信息

Med Educ. 2016 Feb;50(2):181-8. doi: 10.1111/medu.12850.

DOI:10.1111/medu.12850

PMID:26812997

Abstract

OBJECTIVE

Receptiveness to interprofessional feedback, which is important for optimal collaboration, may be influenced by 'in-group or out-group' categorisation, as suggested by social identity theory. We used an experimental design to explore how nurses and resident physicians perceive feedback from people within and outside their own professional group.

METHODS

Paediatric residents and nurses participated in a simulation-based team exercise. Two nurses and two physicians wrote anonymous performance feedback for each participant. Participants each received a survey containing these feedback comments with prompts to rate (i) the usefulness (ii) the positivity and (iii) their agreement with each comment. Half of the participants received feedback labelled with the feedback provider's profession (two comments correctly labelled and two incorrectly labelled). Half received unlabelled feedback and were asked to guess the provider's profession. For each group, we performed separate three-way anovas on usefulness, positivity and agreement ratings to examine interactions between the recipient's profession, actual provider profession and perceived provider profession.

RESULTS

Forty-five out of 50 participants completed the survey. There were no significant interactions between profession of the recipient and the actual profession of the feedback provider for any of the 3 variables. Among participants who guessed the source of the feedback, we found significant interactions between the profession of the feedback recipient and the guessed source of the feedback for both usefulness (F1,48 = 25.6; p < 0.001; η(2) = 0.35) and agreement ratings (F1,48 = 8.49; p < 0.01; η(2) = 0.15). Nurses' ratings of feedback they guessed to be from nurses were higher than ratings of feedback they guessed to be from physicians, and vice versa. Among participants who received labelled feedback, we noted a similar interaction between the profession of the feedback recipient and labelled source of feedback for usefulness ratings (F1,92 = 4.72; p < 0.05; η(2) = 0.05).

CONCLUSION

Our data suggest that physicians and nurses are more likely to attribute favourably perceived feedback to the in-group than to the out-group. This finding has potential implications for interprofessional feedback practices.

摘要

目的

社会认同理论表明，对跨专业反馈的接受度对优化协作很重要，可能会受到“内群体或外群体”分类的影响。我们采用实验设计来探究护士和住院医师如何看待来自本专业群体内部和外部人员的反馈。

方法

儿科住院医师和护士参与了一项基于模拟的团队练习。两名护士和两名医师为每位参与者撰写了匿名的绩效反馈。每位参与者都收到一份包含这些反馈意见的调查问卷，并被要求对（i）有用性（ii）积极性以及（iii）他们对每条意见的认同程度进行评分。一半参与者收到的反馈标注了反馈提供者的专业（两条意见标注正确，两条标注错误）。另一半收到未标注的反馈，并被要求猜测提供者的专业。对于每个组，我们分别对有用性、积极性和认同度评分进行了三因素方差分析，以检验接受者专业、实际提供者专业和感知提供者专业之间的相互作用。

结果

50名参与者中有45人完成了调查。对于这3个变量中的任何一个，接受者的专业与反馈提供者的实际专业之间均无显著的相互作用。在猜测反馈来源的参与者中，我们发现对于有用性评分（F1,48 = 25.6；p < 0.001；η(2) = 0.35）和认同度评分（F1,48 = 8.49；p < 0.01；η(2) = 0.15），反馈接受者的专业与猜测的反馈来源之间均存在显著的相互作用。护士对他们猜测来自护士的反馈评分高于他们猜测来自医师的反馈评分，反之亦然。在收到标注反馈的参与者中，我们注意到对于有用性评分，反馈接受者的专业与标注的反馈来源之间存在类似的相互作用（F1,92 = 4.72；p < 0.05；η(2) = 0.05）。