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医疗诊所中的口头反馈与书面反馈

Oral versus written feedback in medical clinic.

作者信息

Elnicki D M, Layne R D, Ogden P E, Morris D K

机构信息

Department of Medicine, West Virginia University, Morgantown 26506, USA.

出版信息

J Gen Intern Med. 1998 Mar;13(3):155-8. doi: 10.1046/j.1525-1497.1998.00049.x.

Abstract

OBJECTIVE

To determine whether residents perceived oral, face-to-face feedback about their continuity clinic performance as better than a similar, written version.

DESIGN

Single-blind, randomized controlled trial.

SETTING

Two university-based, internal medicine residency clinics.

PARTICIPANTS

All 68 internal medicine and combined program (medicine-pediatrics, medicine-psychiatry, medicine-neurology, and preliminary year) residents and their clinic preceptors.

MEASUREMENTS AND MAIN RESULTS

Residents at each program were separately randomized to oral or written feedback sessions with their clinic preceptors. The oral and written sessions followed similar, structured formats. Both groups were later sent questionnaires about aspects of the clinic. Sixty-five (96%) of the residents completed the questionnaire. Eight of the 19 questions dealt with aspects of feedback. A feedback scale was developed from the survey responses to those eight questions (alpha = .86). There were no significant differences in the responses to individual questions or in scale means (p > .20) between the two feedback groups. When each university was analyzed separately, one had a higher scale mean (3.10 vs 3.57, p = .047), but within each university, there were no differences between the oral and written feedback groups (p > .20).

CONCLUSIONS

No differences were observed between the oral and written feedback groups. In attempting to provide better feedback to their residents, medical educators may better apply their efforts to other aspects, such as the frequency of their feedback, rather than the form of its delivery.

摘要

目的

确定住院医师是否认为关于其连续性门诊表现的口头、面对面反馈比类似的书面反馈更好。

设计

单盲随机对照试验。

地点

两所大学附属医院的内科住院医师门诊。

参与者

所有68名内科及联合项目(内科-儿科、内科-精神科、内科-神经科以及预科阶段)的住院医师及其门诊带教老师。

测量指标及主要结果

每个项目的住院医师分别被随机分配接受与门诊带教老师的口头或书面反馈。口头和书面反馈采用类似的结构化形式。两组随后都收到了关于门诊各方面的问卷。65名(96%)住院医师完成了问卷。19个问题中有8个涉及反馈的各个方面。根据对这8个问题的调查回复制定了一个反馈量表(α = 0.86)。两个反馈组在对各个问题的回答或量表均值方面没有显著差异(p > 0.20)。当分别对每所大学进行分析时,其中一所大学的量表均值较高(3.10对3.57,p = 0.047),但在每所大学内部,口头和书面反馈组之间没有差异(p > 0.20)。

结论

口头和书面反馈组之间未观察到差异。在试图为住院医师提供更好的反馈时,医学教育工作者可能应将精力更好地应用于其他方面,比如反馈的频率,而非反馈的形式。

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