is a PGY-4 General Internal Medicine Resident, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
is a PGY-4 Respirology Resident, Division of Respirology, Queen's University, Kingston, Ontario, Canada.
J Grad Med Educ. 2023 Feb;15(1):74-80. doi: 10.4300/JGME-D-22-00222.1.
Whether written comments in entrustable professional activities (EPAs) translate into high-quality feedback remains uncertain.
We aimed to evaluate the quality of EPA feedback completed by faculty and senior residents.
Using retrospective descriptive analysis, we assessed the quality of feedback from all EPAs for 34 first-year internal medicine residents from July 2019 to May 2020 at Western University in London, Ontario, Canada. We assessed feedback quality on 4 domains: timeliness, task orientation, actionability, and polarity. Four independent reviewers were blinded to names of evaluators and learners and were randomized to assess each EPA for the 4 domains. Statistical analyses were completed using R 3.6.3. Chi-square or Fisher's exact test and Cochran-Armitage test for trend were used to compare the quality of feedback provided by faculty versus student assessors, and to compare the effect of timely versus not timely feedback on task orientation, actionability, and polarity.
A total of 2471 EPAs were initiated by junior residents. Eighty percent (n=1981) of these were completed, of which 61% (n=1213) were completed by senior residents. Interrater reliability was almost perfect for timeliness (κ=0.99), moderate for task orientation (κ=0.74), strong for actionability (κ=0.81), and moderate for polarity (κ=0.62). Of completed EPAs, 47% (n=926) were timely, 85% (n=1697) were task oriented, 83% (n=1649) consisted of reinforcing feedback, 4% (n=79) contained mixed feedback, and 12% (n=240) had neutral feedback. Thirty percent (n=595) were semi- or very actionable.
The written feedback in the EPAs was task oriented but was neither timely nor actionable. The majority of EPAs were completed by senior residents rather than faculty.
委托专业活动（EPAs）中的书面评语是否能转化为高质量的反馈仍不确定。
我们旨在评估教师和高级住院医师完成的 EPA 反馈质量。
使用回顾性描述性分析，我们评估了 2019 年 7 月至 2020 年 5 月在加拿大安大略省伦敦西部大学的 34 名第一年内科住院医师的所有 EPA 的反馈质量。我们在 4 个领域评估了反馈质量：及时性、任务导向、可操作性和极性。4 名独立评审员对评估者和学习者的姓名不知情，并随机分配评估每个 EPA 在这 4 个领域的反馈质量。使用 R 3.6.3 完成统计分析。卡方检验或 Fisher 精确检验和 Cochran-Armitage 趋势检验用于比较教师和学生评估者提供的反馈质量，并比较及时和非及时反馈对任务导向、可操作性和极性的影响。
共有 2471 项初级住院医师发起的 EPA，其中 80%（n=1981）完成，其中 61%（n=1213）由高级住院医师完成。及时性的组内相关系数几乎为完美（κ=0.99），任务导向的为中度（κ=0.74），可操作性的为强（κ=0.81），极性的为中度（κ=0.62）。在已完成的 EPAs 中，47%（n=926）是及时的，85%（n=1697）是任务导向的，83%（n=1649）是强化反馈，4%（n=79）是混合反馈，12%（n=240）是中性反馈。30%（n=595）是半可操作性或非常可操作性。
EPA 中的书面反馈是任务导向的，但既不及时也不可操作。大多数 EPA 是由高级住院医师而不是教师完成的。
