Feedback op de spoedeisende hulp

Yarris LM, Linden JA, Gene HH, Lefebvre C, Nestler DM, Fu R, et al. Attending and resident satisfaction with feedback in the emergency department. Acad Emerg Med 2009 Dec;16 Suppl 2:S76-S81

DOELSTELLINGEN: Effectieve feedback is essentieel voor medisch onderwijs. Er is weinig bekend over de percepties over feedback van artsen. De focus van deze studie was om de perceptie over de educatieve feedback die de behandelende artsen geven aan assistenten in de klinische omgeving van de afdeling spoedeisende hulp te onderzoeken. De auteurs vergeleken tevredenheid onder artsen en assistenten over de feedback en de hypothese dat de twee groepen verschillende meningen zouden hebben over de tevredenheid met de feedback die ze momenteel geven en ontvangen op de spoedeisende hulp

OBJECTIVES: Effective feedback is critical to medical education. Little is known about emergency medicine (EM) attending and resident physician perceptions of feedback. The focus of this study was to examine perceptions of the educational feedback that attending physicians give to residents in the clinical environment of the emergency department (ED). The authors compared attending and resident satisfaction with real-time feedback and hypothesized that the two groups would report different overall satisfaction with the feedback they currently give and receive in the ED. METHODS: This observational study surveyed attending and resident physicians at 17 EM residency programs through web-based surveys. The primary outcome was overall satisfaction with feedback in the ED, ranked on a 10-point scale. Additional survey items addressed specific aspects of feedback. Responses were compared using a linear generalized estimating equation (GEE) model for overall satisfaction, a logistic GEE model for dichotomized responses, and an ordinal logistic GEE model for ordinal responses. RESULTS: Three hundred seventy-three of 525 (71%) attending physicians and 356 of 596 (60%) residents completed the survey. Attending physicians were more satisfied with overall feedback (mean score 5.97 vs. 5.29, p < 0.001) and with timeliness of feedback (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.23 to 2.00; p < 0.001) than residents. Attending physicians were also more likely to rate the quality of feedback as very good or excellent for positive feedback, constructive feedback, feedback on procedures, documentation, management of ED flow, and evidence-based decision-making. Attending physicians reported time constraints as the top obstacle to giving feedback and were more likely than residents to report that feedback is usually attending initiated (OR = 7.09, 95% CI = 3.53 to 14.31; p < 0.001). CONCLUSIONS: Attending physician satisfaction with the quality, timeliness, and frequency of feedback given is higher than resident physician satisfaction with feedback received. Attending and resident physicians have differing perceptions of who initiates feedback and how long it takes to provide effective feedback. Knowledge of these differences in perceptions about feedback may be used to direct future educational efforts to improve feedback in the ED

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