Mims Lisa D, DeCastro Alexei O, Kelly Ann G
Department of Family Medicine, Medical University of South Carolina.
Fam Med. 2017 Oct;49(9):699-705.
Forward feeding signifies sharing information about learners for purposes of professional and academic advancement, and promotes progression toward a competency-based educational continuum. The aim of this study is to assess reasons for difficulty or failure of the family medicine clerkship and investigate utilization and methods of forward feeding. Reasons behind medical school policies regarding forward feeding are also evaluated.
Data were collected through the 2013 Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) Family Medicine Clerkship Director survey. Directors rated reasons for clerkship difficulty or failure on a 6-point Likert scale. They also reported if they utilized forward feeding, to whom, and the communication method used. Finally, they were asked about factors influencing institutional policy toward forward feeding, including threats of litigation. RESULTS were compared between public and private schools, and based on tenure as clerkship director. Analyses were performed using chi-square or Fisher's exact test.
Knowledge deficits were the most common reason for clerkship difficulty and failure, followed by professionalism difficulties. Over half of respondents engage in forward feeding, and almost all pass this information to other clerkship directors. Concern for student privacy and faculty bias were noted as two important factors influencing school policy. While almost half of respondents felt that litigation fears influenced their school's approach to forward feeding, few were aware of any related litigation.
Forward feeding is only utilized by half of clerkship directors. More studies regarding the potential impacts of this practice are warranted.
正向反馈是指为了促进专业和学术发展而分享有关学习者的信息，并推动向基于能力的教育连续体发展。本研究的目的是评估家庭医学实习困难或失败的原因，并调查正向反馈的利用情况和方法。同时也评估医学院校正向反馈政策背后的原因。
通过2013年学术家庭医学理事会（CAFM）教育研究联盟（CERA）家庭医学实习主任调查收集数据。主任们用6点李克特量表对实习困难或失败的原因进行评分。他们还报告了是否使用正向反馈、反馈对象以及所采用的沟通方式。最后，他们被问及影响学校正向反馈政策的因素，包括诉讼威胁。对公立和私立学校以及根据实习主任任期的结果进行了比较。使用卡方检验或费舍尔精确检验进行分析。
知识缺陷是实习困难和失败的最常见原因，其次是职业素养方面的困难。超过一半的受访者进行正向反馈，并且几乎所有人都将这些信息传递给其他实习主任。对学生隐私的担忧和教师偏见被认为是影响学校政策的两个重要因素。虽然近一半的受访者认为对诉讼的担忧影响了学校对正向反馈的态度，但很少有人知晓任何相关诉讼。
只有一半的实习主任使用正向反馈。有必要对这种做法的潜在影响进行更多研究。
