Improving Narrative Feedback for Resident-Led Academic Rounds: The Effects of Assessment Form Design Changes.

Abstract

Learners benefit more from narrative feedback than numerical scores on formative assessments, yet they often report that feedback is lacking in quality and quantity. Changes to the formatting of assessment forms is a practical intervention with limited literature regarding its impact on feedback. This study explores the effect of a formatting change (ie, relocating the comment section from the bottom of a form to the top) on residents' oral presentation assessment forms and if this affects the quality of narrative feedback. We used a feedback scoring system based on the theory of deliberate practice to evaluate the quality of written feedback provided to psychiatry residents on assessment forms from January to December 2017 before and after a form design change. Word count and presence of narrative comments were also assessed. Ninety-three assessment forms with the comment section at bottom and 133 forms with the comment section at the top were evaluated. When the comment section was placed at the top of the evaluation form, there were significantly more comment sections with any number of words than left blank (X 2(1)=6.54, P=.011) as well as a significant increase in the specificity related to the task component, or what was done well (X 2(3)=20.12, P≤.0001). More prominent placement of the feedback section on assessment forms increased the number of sections filled as well as the specificity related to the task component.