Valentine Jake, Jung Julianna
Department of Emergency Medicine HCA Houston Healthcare Kingwood Kingwood Texas USA.
Department of Clinical Sciences University of Houston College of Medicine Houston Texas USA.
AEM Educ Train. 2024 Aug 19;8(4):e11016. doi: 10.1002/aet2.11016. eCollection 2024 Aug.
Multisource and 360-degree feedback are emerging methods in the medical education assessment literature. Nursing feedback in particular has been identified as a point of emphasis regarding what medical education leadership would most value for incorporating into their evaluations. There is no currently accepted tool for multisource feedback in the emergency department (ED). To answer this call, we conducted a qualitative study to elucidate nurse perspectives on evaluation of emergency medicine residents.
We conducted individual semistructured interviews of ED nurses with experience working alongside residents via volunteer recruitment. Transcripts were coded independently by each author and then reviewed collaboratively to resolve differences. Codes were created by inductive thematic analysis and subsequently underwent constant comparison and classical content analysis. Recruitment continued until analysis of transcripts showed thematic saturation.
We organized the interview transcript into chunks of information, arranging 407 quotes from the 10 interview transcripts into 17 codes and six themes regarding observable resident behaviors. Representative quotes and exemplar cases added detailed description to the meaning of these codes. The identified themes for observable resident behaviors included "general communication style," "medical knowledge," "efficiency," "patient communication," "nurse communication," and "professionalism." An additional 13 codes addressed the themes of barriers and catalysts for feedback.
The identified themes on observable resident behaviors aligned well with prior literature and with the Accreditation Council for Graduate Medical Education (ACGME) Milestones. The interviews also highlighted nurse perspectives on barriers and catalysts for feedback that would be useful to incorporate into the design of an assessment tool.
多源和360度反馈是医学教育评估文献中新兴的方法。特别是护理反馈已被确定为医学教育领导者在评估中最重视纳入的重点内容。目前急诊科（ED）尚无公认的多源反馈工具。为了回应这一需求，我们进行了一项定性研究，以阐明护士对急诊医学住院医师评估的看法。
我们通过志愿者招募对有与住院医师共事经验的急诊科护士进行了个人半结构化访谈。每位作者独立对访谈记录进行编码，然后共同审核以解决差异。通过归纳主题分析创建代码，随后进行持续比较和经典内容分析。持续招募直至访谈记录分析显示主题饱和。
我们将访谈记录整理成信息块，将10份访谈记录中的407条引述整理成17个代码和6个关于住院医师可观察行为的主题。代表性引述和示例案例为这些代码的含义增添了详细描述。确定的住院医师可观察行为主题包括“一般沟通风格”、“医学知识”、“效率”、“与患者沟通”（“patient communication”）、“与护士沟通”以及“专业素养”。另外13个代码涉及反馈的障碍和促进因素主题。
确定的住院医师可观察行为主题与先前文献以及研究生医学教育认证委员会（ACGME）的里程碑相一致。访谈还突出了护士对反馈障碍和促进因素的看法，这些看法有助于纳入评估工具的设计。
