Raikhel Andrew V, Starks Helene, Berger Gabrielle, Redinger Jeffrey
Department of Hospital Medicine, VA (Veteran's Affairs) Puget Sound Healthcare System, Seattle Division, Seattle, USA.
Department of General Internal Medicine, University of Washington, Seattle, USA.
Cureus. 2024 Jun 29;16(6):e63459. doi: 10.7759/cureus.63459. eCollection 2024 Jun.
Feedback is critical for resident growth and is most effective when the relationship between residents and attendings is collaborative, with shared expectations for the purpose, timing, and manner of communication for feedback. Within internal medicine, there is limited work exploring the resident and hospitalist perspectives on whether key elements are included in feedback sessions.
We surveyed internal medicine residents and supervising hospitalists at a large urban training program about their perspectives on four components of effective feedback: specificity,timeliness, respectful communication, and actionability.
We received surveys from 130/184 internal medicine residents and 74/129 hospitalists (71% and 57% response rate, respectively). Residents and hospitalists differed in their perspectives about specificity and timeliness: 54% (70/129) of residents reported they did not receive specific feedback while 90% (65/72) of hospitalists reported they delivered specific feedback (p<0.01), and 33% (43/129) of residents compared with 82% (59/72) of hospitalists perceived feedback as timely (p<0.01). Internal medicine residents and hospitalists reported concordant rates of feedback sessions consisting of a two-way conversation (84%, 109/129; 89%, 64/72, respectively, p=0.82) and that communication was delivered in a respectful manner (95%, 122/129; 97%, 70/72, respectively, p=0.57).
We observed discordance between internal medicine residents and supervising hospitalist perspectives on the inclusion of two critical components of feedback: specificity and timing. The hospitalist cohort reported delivering more components of effective feedback than the resident cohort reported receiving. The etiology of this discordance is likely multifactorial and requires further investigation.
反馈对于住院医师的成长至关重要，当住院医师与主治医生之间的关系具有协作性，且对反馈的目的、时机和沟通方式有共同期望时，反馈最为有效。在内科领域，关于反馈环节是否包含关键要素，探讨住院医师和医院医生观点的研究较少。
我们对一个大型城市培训项目中的内科住院医师和指导医院医生进行了调查，了解他们对有效反馈的四个组成部分的看法：具体性、及时性、尊重性沟通和可操作性。
我们收到了130名/184名内科住院医师和74名/129名医院医生的调查问卷（回复率分别为71%和57%）。住院医师和医院医生在对具体性和及时性的看法上存在差异：54%（70/129）的住院医师表示他们没有收到具体反馈，而90%（65/72）的医院医生表示他们提供了具体反馈（p<0.01）；33%（43/129）的住院医师认为反馈及时，而82%（59/72）的医院医生有此看法（p<0.01）。内科住院医师和医院医生报告的反馈环节包含双向对话的比例一致（分别为84%，109/129；89%，64/72，p=0.82），且沟通方式具有尊重性的比例也一致（分别为95%，122/129；97%，70/72，p=0.57）。
我们观察到内科住院医师和指导医院医生在反馈的两个关键组成部分（具体性和时机）的包含情况上存在不一致。医院医生群体报告提供的有效反馈组成部分比住院医师群体报告收到的更多。这种不一致的原因可能是多方面的，需要进一步调查。
