A Targeted Feedback Framework to Move the Needle on Operative Feedback.

OBJECTIVE

Actionable and impactful feedback remains a perpetual challenge in medical education despite extensive efforts to improve the feedback process. A feedback framework was adapted from a validated model and tailored to a single residency program. The purpose of this study was to evaluate the impact of the new feedback framework on the quantity and quality of perioperative feedback amongst surgical residents.

DESIGN

A nonrandomized interventional study was conducted in a general surgery residency program at a single academic institution over a 6-month study period. The new 'Brainstorm', 'Focus', and 'Recap' (BFR) feedback framework was introduced to surgical faculty and residents on 2 surgical services. Posters of the framework were displayed in the operating rooms and scrub sinks. Regular reminder emails were sent, and competitions were held to encourage engagement. Pre and postintervention surveys were distributed electronically to all participants.

SETTING

Brigham and Women's Hospital Department of Surgery in Boston, MA.

PARTICIPANTS

A total of 19 faculty and 56 residents inclusive of 2 general surgery services (trauma and acute care surgery; minimally invasive and bariatric surgery).

RESULTS

Faculty reported giving more frequent and higher quality feedback than residents reported receiving, before and after the intervention. There was increased satisfaction with technical feedback following the intervention, which was reported by both faculty (27.3%-73.3%, p = 0.01) and upper-level residents (17.7%-54.6%, p = 0.02). Faculty and residents mutually indicated improved overall feedback breadth (faculty 58.2%-78.7%, p = 0.01; residents 41.6%-54.3%, p = 0.03).

CONCLUSIONS

The introduction of a tailor-made framework that utilizes a structured, shared mental model to promote goal-oriented feedback improved faculty and resident practices and perceptions of perioperative feedback. Nevertheless, a disparity between faculty and resident perceptions persists. More work is needed to overcome the complexities of the surgical learning environment and better align faculty and resident perceptions.