Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran.
Institute of Neuropharmacology, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
BMC Med Educ. 2024 Apr 19;24(1):424. doi: 10.1186/s12909-024-05398-y.
Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents' perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training.
This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents' perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents.
The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting.
Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents' perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care.
反馈是临床环境中学习过程的关键组成部分。本研究旨在探讨住院医师对反馈的看法，并确定临床培训中寻求反馈的潜在障碍。
本横断面研究涉及 17 个专业的 180 名住院医师。我们采用经过验证的住院医师临床培训反馈水平评估工具（REFLECT）来评估住院医师对反馈的态度、反馈质量、感知重要性以及对反馈的反应。此外，我们还探讨了住院医师寻求反馈的行为障碍。
大多数住院医师对反馈持积极态度。他们同意反馈可以提高他们的临床表现（77.7%）、职业行为（67.2%）和学术动机（56.7%），同时也影响他们在未来职业生涯中成为更好的专家（72.8%）。然而，研究揭示了反馈过程中的关键缺陷。只有 25.6%的住院医师报告定期接受反馈，不到一半的人报告反馈在适当的时间和地点持续提供，反馈足够清晰或包括改进的可操作计划。少数（32.2%）人同意教师有足够的技能来有效地提供反馈。此外，住院医师之间的同伴反馈似乎是反馈的主要来源。负面反馈虽然必要，但往往会引发压力、尴尬或羞辱感。值得注意的是，不同专业之间的反馈认知没有显著差异。缺乏寻求反馈的文化是临床环境中寻求反馈行为的主要障碍。
建立共同的期望并促进寻求反馈的文化可以缩小住院医师的认知与教师反馈提供之间的差距。此外，认识到高级和同伴住院医师作为有价值的反馈来源的作用，可以促进临床培训中更有效的反馈过程，最终有益于住院医师的发展和患者的护理。
