Department of Emergency Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN, 55904, USA.
Department of Emergency Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA.
BMC Med Educ. 2018 Oct 3;18(1):225. doi: 10.1186/s12909-018-1333-9.
Clinical feedback is an important part of residency training, yet literature suggests this complex interaction is not completely understood. In particular, little is known about what resident versus attending physicians expect as feedback. This study investigates this gap in knowledge by examining differences in interactions that residents and attendings view as feedback.
Surveys containing sample clinical feedback scenarios were distributed to residents and attending physicians in emergency medicine and general surgery at a large academic medical center. Respondents were asked to decide whether useful feedback was provided in each scenario, and responses were compared between the two groups. Continuous features were summarized with medians, interquartile ranges (IQRs), and ranges; categorical features were summarized with frequency counts and percentages. Comparisons of features between residents and attendings were evaluated using Wilcoxon rank sum, chi-square, and Fisher exact tests. Statistical analyses were performed using version 9.4 of the SAS software package (SAS Institute, Inc.; Cary, NC). All tests were two-sided and p-values < 0.05 were considered statistically significant.
Seventy-two individuals responded to the survey out of approximately 110 invitations sent (65%), including 35 (49%) residents and 37 (51%) attendings. Of 35 residents, 31 indicated their level of training, which included 13 (42%) PGY-1, 9 (29%) PGY-2, 6 (19%) PGY-3, and 3 (10%) PGY-4, respectively. Of 37 attendings, 34 indicated the number of years since completion of residency or last fellowship, at a median of 9 years (IQR 4-14; range 1-31). No significant difference was found in residents' and attendings' perceptions of what constituted feedback in the sample scenarios.
While this study did not find a statistical difference in perception of feedback between residents and attendings, additional factors should be considered when investigating perceived feedback deficiencies. Further research is needed to better understand and improve the clinical feedback process.
临床反馈是住院医师培训的重要组成部分，但文献表明，这种复杂的相互作用并未被完全理解。特别是，人们对住院医师和主治医生期望得到什么样的反馈知之甚少。通过检查住院医师和主治医生认为是反馈的交互作用的差异，本研究填补了这一知识空白。
在一家大型学术医疗中心的急诊医学和普通外科向住院医师和主治医生分发了包含示例临床反馈情景的调查问卷。要求受访者判断每个情景中是否提供了有用的反馈，然后比较两组的回答。连续特征用中位数、四分位距（IQR）和范围总结；分类特征用频数和百分比总结。使用 Wilcoxon 秩和检验、卡方检验和 Fisher 精确检验比较住院医师和主治医生之间的特征。统计分析使用 SAS 软件包 9.4 版（SAS Institute，Inc.；Cary，NC）进行。所有检验均为双侧检验，p 值<0.05 认为具有统计学意义。
在发出的约 110 份邀请中，有 72 人（65%）对调查做出了回应，包括 35 名（49%）住院医师和 37 名（51%）主治医生。在 35 名住院医师中，有 31 名报告了他们的培训水平，其中包括 13 名（42%）PGY-1、9 名（29%）PGY-2、6 名（19%）PGY-3 和 3 名（10%）PGY-4。在 37 名主治医生中，有 34 名报告了他们完成住院医师培训或最近的进修培训后的年限，中位数为 9 年（IQR 4-14；范围 1-31）。在样本情景中，住院医师和主治医生对构成反馈的看法没有明显差异。
尽管本研究没有发现住院医师和主治医生对反馈的看法存在统计学差异，但在调查反馈缺陷时应考虑其他因素。需要进一步研究以更好地理解和改善临床反馈过程。
