Chaou Chung-Hsien, Monrouxe Lynn V, Chang Li-Chun, Yu Shiuan-Ruey, Ng Chip-Jin, Lee Ching-Hsing, Chang Yu-Che
a Chang-Gung Medical Education Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Linkou , Taiwan.
b Department of Emergency Medicine , Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Linkou , Taiwan.
Med Teach. 2017 Nov;39(11):1145-1153. doi: 10.1080/0142159X.2017.1366016. Epub 2017 Aug 22.
Feedback is an effective pedagogical tool in clinical teaching and learning, but is often perceived as unsatisfactory. Little is known about the effect of a busy clinical environment on feedback-giving and -seeking behaviors. This study aims to determine the perceptions and challenges of feedback provision in a busy clinical setting, exemplified by an emergency department (ED).
A qualitative semi-structured interview study design was employed. Thirty-six participants (18 attending physicians, 18 residents) were purposively sampled from three EDs in northern Taiwan between August 2015 and July 2016. Interviews were recorded, transcribed, and analyzed thematically.
Three major themes were identified with illustrative quotes: (1) the balance between patient safety and providing feedback, (2) variability in feedback, and (3) influential factors, barriers and enablers.
In real practice, clinical duties competed with the impulse to provide feedback. The variety and complexity of feedback extended beyond style and content. Clinical and contextual factors - some of which may be presented as barriers - influenced how, when and whether a teacher or learner decided to give or seek feedback.
反馈是临床教学中一种有效的教学工具，但常常被认为不尽人意。对于繁忙的临床环境对反馈给予和寻求行为的影响知之甚少。本研究旨在确定在以急诊科（ED）为例的繁忙临床环境中提供反馈的认知和挑战。
采用定性半结构化访谈研究设计。2015年8月至2016年7月期间，从台湾北部的三个急诊科中 purposively 抽取了36名参与者（18名主治医师，18名住院医师）。对访谈进行录音、转录并进行主题分析。
确定了三个主要主题及示例引述：（1）患者安全与提供反馈之间的平衡，（2）反馈的变异性，以及（3）影响因素、障碍和促成因素。
在实际操作中，临床职责与提供反馈的冲动相互竞争。反馈的多样性和复杂性超出了风格和内容的范畴。临床和背景因素——其中一些可能表现为障碍——影响着教师或学习者决定如何、何时以及是否给予或寻求反馈。
