DeCastro Alexei O, Mims Lisa D, Stephens Mark B, Chessman Alexander W
Department of Family Medicine, Medical University of South Carolina, Charleston, SC.
Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA.
Fam Med. 2019 Apr;51(4):326-330. doi: 10.22454/FamMed.2019.113783.
"Forward feeding" is defined as the sharing of information regarding learner behaviors and performance outside of formal institutional committee structures. The purpose of this study was to establish baseline opinions and policies of forward feeding in family medicine residency programs.
Data for this study were obtained as part of the 2015 CERA Program Directors Fall Survey. Program directors indicated whether they felt that faculty should and do engage in forward feeding. Respondents were asked to rate the importance of various types of information about learners (academic performance, clinical performance, professionalism, physical health, and mental health), reasons for promoting, and concerns regarding forward feeding on a 5-point Likert scale.
The overall response rate was 49% (227/461). Most agreed that faculty should (87%) and do (83%) engage in forward feeding. Concerns regarding professionalism and clinical performance were reported as most important to share. The most important reason identified for forward feeding was the early identification of struggling residents, followed by the ability to direct teaching to the resident's specific needs, and improving the quality of feedback. Fear of creating bias was the most commonly cited concern for engaging in forward feeding, followed by fear of violating confidentiality and difficulty maintaining confidentiality. Fear of litigation was the least common concern.
Despite concerns, the majority of program directors feel that faculty should and do engage in forward feeding. Our study confirms the importance of clinical performance and professionalism as two important themes of information shared by attendings about residents.
“正向反馈”被定义为在正式的机构委员会结构之外分享有关学习者行为和表现的信息。本研究的目的是确定家庭医学住院医师培训项目中正向反馈的基线意见和政策。
本研究的数据作为2015年CERA项目主任秋季调查的一部分获得。项目主任指出他们是否认为教员应该且确实进行正向反馈。受访者被要求在5点李克特量表上对关于学习者的各种类型信息（学业成绩、临床能力、职业素养、身体健康和心理健康）、促进正向反馈的原因以及对正向反馈的担忧的重要性进行评分。
总体回复率为49%（227/461）。大多数人同意教员应该（87%）且确实（83%）进行正向反馈。据报告，关于职业素养和临床能力的担忧对于分享最为重要。确定的正向反馈的最重要原因是早期识别有困难的住院医师，其次是能够根据住院医师的特定需求指导教学以及提高反馈质量。参与正向反馈最常被提及的担忧是害怕产生偏见，其次是害怕违反保密性以及难以保持保密性。害怕诉讼是最不常见的担忧。
尽管存在担忧，但大多数项目主任认为教员应该且确实进行正向反馈。我们的研究证实了临床能力和职业素养作为带教老师分享的有关住院医师的两个重要信息主题的重要性。
