Feedback in the Education of Oral and Maxillofacial Surgery Residents

Abstract

In surgical residencies, formative feedback on both operative technique and judgment is needed to build adept surgeons. The general surgery literature indicates deficiencies thereof, and disparities between resident and faculty perceptions of feedback.1,2 In oral and maxillofacial surgery (OMS), there is a dearth of research on this crucial aspect of education. In this survey-based descriptive study, we aim to characterize variations in feedback-giving strategies utilized in resident education and compare this to their preferred ways of receiving feedback. As a secondary aim, we wish to gauge residents’ satisfaction with the feedback they receive. As a tertiary aim, we wish to compare residents’ and attendings’ perception of said feedback. We hypothesize that residents and faculty will value feedback but may have differing ideas on the content and delivery. To these means, we sent surveys to all OMS residency program directors nationwide, for completion by their residents and faculty (Figures 1, 2). All responses were recorded via a 5-point Likert scale. Responses were grouped into categories of “agree” + “strongly agree,” “neutral,” and “disagree” + “strongly disagree” for statements of preference or agreement, and “almost never” + “seldom,” “sometimes,” “most of the time” + “nearly all of the time” for statements of setting and time. Wilcoxon-Mann-Whitney U tests were used to compare responses between 2 groups, with P < .05 for statistical significance. Our results show significant differences between how feedback is given, based on the residents’ perspective, and how they prefer it be given. Most notably, 79% would like feedback to occur during a postoperative debrief immediately after the case. However, only 27% report that this is the usual setting (P < .0001). Additionally, 92.95% prefer verbal, face-to-face feedback, whereas they agree that it occurs this way 59% of the time (P < .0001). In terms of resident satisfaction, only 47% were satisfied with the current feedback practices. The biggest deficiencies appear to be in the quality and specificity of said feedback, with only 43% agreeing that each of these are adequate. Additionally, only 49% felt the amount was adequate. In regards to faculty vs resident perceptions, significant differences were found in nearly all responses. The groups only agreed on the seldom use of rating tools and the importance of feedback in OMS education, which was nearly unanimous (94% vs 96%). The largest difference was in the use of postoperative debriefing, which faculty reported to occur often (65% of the time), while residents reported only 27% (P < .0001); 94% of faculty responded that feedback is most often delivered verbally, face-to-face, while only 59% of residents agreed (P < .0001). Additionally, 76% of faculty believed the quality of their feedback to be adequate vs only 43% of residents felt this was the case (P < .0001). Our results indicate several issues regarding the current practices of feedback in OMS training. Residents most prefer feedback given verbally, face-to-face, in a postoperative debriefing, while they indicate that this is often not the case. Interestingly, faculty believe that both of these occur significantly more frequently than the residents report. Faculty also believe that the quality of their feedback given is adequate, while residents disagree. Overall, it appears that resident satisfaction with current practices is low, and our study identifies multiple opportunities for improvement. Figure 2Faculty RedCap Survey View Large Image Figure Viewer Download Hi-res image