Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA.
BMJ Open. 2024 Nov 9;14(11):e082726. doi: 10.1136/bmjopen-2023-082726.
Providing clinical performance feedback to physicians is an established method to improve care, but the impact on physician well-being is unclear. This evaluation aimed to better understand physician perspectives on clinical feedback and its potential impact on well-being.
A qualitative design using semi-structured interviews was undertaken. Data were analysed via consensus coding using an inductive-deductive approach informed by Clinical Performance Feedback Intervention Theory. Findings were used to develop a novel framework describing the relationship between feedback and well-being.
Interviews were conducted in a large academic medical centre from June-September 2021.
We conducted 25 semi-structured interviews with general outpatient and inpatient paediatricians and internists.
Physicians felt that feedback supported well-being based on its perceived purpose (intended to promote professional growth vs serving an alternative purpose), which they discerned based on feedback content (aligned with physician priorities vs not aligned), validity (accurate vs inaccurate), actionability (specific vs not, within a physician's sphere of control vs not) and delivery (supportive vs punitive). The Clinical Performance Feedback Well-Being Model is presented to understand how feedback and recipient variables impact well-being.
Attention to the process and content of physician clinical performance feedback may advance both the quality of care and physician well-being.
向医生提供临床绩效反馈是改善医疗服务的一种既定方法，但对医生福祉的影响尚不清楚。本评估旨在更好地了解医生对临床反馈的看法及其对幸福感的潜在影响。
采用半结构式访谈的定性设计。使用基于临床绩效反馈干预理论的共识编码对数据进行分析，采用归纳演绎方法。研究结果用于开发一个新的框架，描述反馈与幸福感之间的关系。
2021 年 6 月至 9 月，在一家大型学术医疗中心进行访谈。
我们对 25 名普通门诊和住院儿科医生和内科医生进行了半结构式访谈。
医生们认为反馈可以通过其感知目的（旨在促进专业成长，还是有其他目的）来支持幸福感，他们根据反馈内容（与医生的重点一致，还是不一致）、准确性（准确，还是不准确）、可操作性（具体，还是不具体，在医生的控制范围内，还是不在）和传递方式（支持性，还是惩罚性）来判断反馈的目的。提出了临床绩效反馈幸福感模型，以了解反馈和接受者变量如何影响幸福感。
关注医生临床绩效反馈的过程和内容，可能会提高医疗服务质量和医生的幸福感。
