Improving Faculty Feedback to Resident Trainees during a Simulated Case: A Randomized, Controlled Trial of an Educational Intervention
Abstract
Background: Although feedback conversations are an essential component of learning, three challenges make them difficult: the fear that direct task feedback will harm the relationship with the learner, overcoming faculty cognitive biases that interfere with their eliciting the frames that drive trainees’ performances, and time pressure. Decades of research on developmental conversations suggest solutions to these challenges: hold generous inferences about learners, subject one’s own thinking to test by making it public, and inquire directly about learners’ cognitive frames. Methods: The authors conducted a randomized, controlled trial to determine whether a 1-h educational intervention for anesthesia faculty improved feedback quality in a simulated case. The primary outcome was an analysis of the feedback conversation between faculty and a simulated resident (actor) by using averages of six elements of a Behaviorally Anchored Rating Scale and an objective structured assessment of feedback. Seventy-one Harvard faculty anesthesiologists from five academic hospitals participated. Results: The intervention group scored higher when averaging all ratings. Scores for individual elements showed that the intervention group performed better in maintaining a psychologically safe environment (4.3 ± 1.21 vs . 3.8 ± 1.16; P = 0.001), identifying and exploring performance gaps (4.1 ± 1.38 vs . 3.7 ± 1.34; P = 0.048), and they more frequently emphasized the professionalism error of failing to call for help over the clinical topic of anaphylaxis (66 vs . 41%; P = 0.008). Conclusions: Quality of faculty feedback to a simulated resident was improved in the interventional group in a number of areas after a 1-h educational intervention, and this short intervention allowed a group of faculty to overcome enough discomfort in addressing a professionalism lapse to discuss it directly.
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The quality of feedback improves after specific training of clinical faculty.
“It is encouraging that this need not be the case, and the quality of feedback improves after specific training of clinical faculty [29, 54, 55].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [54]
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Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education.
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- Authors
- Minehart, R. D., Rudolph, J., Pian-Smith, M. C. M., & Raemer, D. B.
- Affiliations
- Boston College (US)
- Corresponding author
- Minehart, Rebecca D.
- Venue
- Anesthesiology
- Published
- 2014-01
- Volume
- 120
- Issue
- 1
- Pages
- 160-171
- ISSN
- 0003-3022 (ISSN-L)
- OpenAlex
- W2029054902
- Cited by
- 57
- References
- 41
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 8 · 2021: 7 · 2020: 8 · 2019: 8 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 5 · 2014: 5
- FWCI
- 4.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anesthesiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- instructor feedback, residency training, simulated cases, cognitive biases, psychological safety, professionalism, behaviorally anchored rating scales, educational intervention
- MeSH terms
- Adult, Anti-Bacterial Agents, Clinical Competence, Drug Hypersensitivity, Education, Medical, Graduate, Educational Measurement, Faculty, Feedback, Female, Humans, Internship and Residency, Learning, Male, Mental Processes, Research, Teaching, Observer Variation, Patient Simulation, Medical Errors, Professional Role
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