The feedback dilemma in medical education: insights from medical residents' perspectives.

Sara Shafian, Mehran Ilaghi, Yasamin Shahsavani, Maryam Okhovati, Adel Soltanizadeh, Sarah Aflatoonian, Ali Karamoozian
Author Information
  1. Sara Shafian: Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran.
  2. Mehran Ilaghi: Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran. mehranila@gmail.com.
  3. Yasamin Shahsavani: Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran.
  4. Maryam Okhovati: Medical Informatics Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
  5. Adel Soltanizadeh: Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran.
  6. Sarah Aflatoonian: Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran.
  7. Ali Karamoozian: Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran.

Abstract

BACKGROUND: Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents' perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training.
METHODS: This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents' perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents.
RESULTS: The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting.
CONCLUSIONS: Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents' perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care.

Keywords

References

  1. Ann Allergy Asthma Immunol. 2022 Mar;128(3):256-262 [PMID: 34929390]
  2. J Grad Med Educ. 2012 Jun;4(2):154-8 [PMID: 23730434]
  3. Cureus. 2019 May 10;11(5):e4633 [PMID: 31312559]
  4. Med Teach. 2005 Aug;27(5):470-2 [PMID: 16147804]
  5. Acad Med. 2016 Jun;91(6):807-12 [PMID: 26556298]
  6. Acad Emerg Med. 2009 Dec;16 Suppl 2:S76-81 [PMID: 20053217]
  7. Med Teach. 2002 May;24(3):245-8 [PMID: 12098410]
  8. J Clin Anesth. 2013 Nov;25(7):560-4 [PMID: 24008192]
  9. Am J Surg. 2016 Feb;211(2):464-75 [PMID: 26679827]
  10. Med Educ. 2020 Jan;54(1):33-39 [PMID: 31475387]
  11. J Grad Med Educ. 2015 Jun;7(2):208-13 [PMID: 26221436]
  12. Med Teach. 2017 Nov;39(11):1145-1153 [PMID: 28830288]
  13. Med Educ Online. 2022 Dec;27(1):2077687 [PMID: 35583293]
  14. Med Teach. 2020 Nov;42(11):1289-1297 [PMID: 32805145]
  15. Med Sci Educ. 2021 Oct 18;31(6):2093-2104 [PMID: 34956714]
  16. JAMA. 1983 Aug 12;250(6):777-81 [PMID: 6876333]
  17. Clin Teach. 2013 Feb;10(1):9-14 [PMID: 23294737]
  18. Acad Med. 2015 May;90(5):609-14 [PMID: 25406607]
  19. BMC Med Educ. 2023 May 17;23(1):344 [PMID: 37198635]
  20. J Grad Med Educ. 2010 Dec;2(4):646-8 [PMID: 22132293]
  21. Med Teach. 2013 Dec;35(12):e1625-31 [PMID: 23848343]

MeSH Term

Humans
Internship and Residency
Cross-Sectional Studies
Feedback
Motivation
Peer Group
Clinical Competence

Word Cloud

Created with Highcharts 10.0.0feedbackresidentsmedicalclinicalfeedback-seekingresidents'FeedbackstudyperspectivestrainingbehavioramongcriticalprocesssettingdeliverybarriersspecialtiesClinicaltowardagreed7%2%reportedfacultyperceptionscultureMedicalBACKGROUND:componentlearningaimsexploreidentifypotentialMETHODS:cross-sectionalinvolved180acrossseventeenemployedvalidatedResidencyEducationLevelEvaluationTrainingREFLECTtoolassessattitudequalityperceivedimportancereactionAdditionallyexploredRESULTS:majorityheldpositiveattitudesimprovesperformance77professional67academicmotivation56alsoinfluencingbecomebetterspecialistfuturecareer728%Howeverrevealeddeficiencies256%receivingregularlesshalfconsistentlydeliveredsuitabletimeslocationssufficientlyclearincludedactionableplansimprovementminority32sufficientskillsdelivereffectivelyMoreoverpeer-to-peerappearedprimarysourceNegativethoughnecessaryoftentriggeredfeelingsstressembarrassmenthumiliationNotablysignificantdifferencesdifferentabsenceemergedcentralbarrierCONCLUSIONS:EstablishingsharedexpectationspromotingbridgegapFurthermorerecognizingroleseniorpeervaluablesourcescancontributeeffectiveprocessesultimatelybenefitingresidentdevelopmentpatientcaredilemmaeducation:insightseducation

Similar Articles

Cited By