Abstract
PurposeTo investigate the association of medical learner feedback with patient management and outcomes.MethodsThe authors investigated 27 articles that utilized patient data or chart reviews as a subset of a prior feedback scoping review. Data extraction was completed by two authors and all authors reviewed the descriptive data analysis.ResultsThe studies were predominantly short-term investigations conducted in the US at academic teaching hospitals (89%) with one medical discipline (78%), most commonly internal medicine (56%). Patient-related outcomes primarily involved improved documentation (26%) and adherence to practice guidelines (19%) and were mostly measured through chart reviews (56%) or direct observation (15%). The primary method of feedback delivery involved a written format (30%). The majority of the studies showed a positive effect of feedback on the patient-oriented study outcomes (82%), although most involved a non-rigorous study design.ConclusionsPublished studies focusing on the relationship between medical learner feedback and patient care are sparse. Most involve a single discipline at a single institution and are of a non-rigorous design. Measurements of improved patient outcomes are restricted to changes in management, procedures and documentation. Well-designed studies that directly link learner feedback to patient outcomes may help to support the use of feedback in teaching clinical outcomes improvement in alignment with competency-based milestones.Electronic supplementary materialThe online version of this article (10.1007/s40037-017-0375-8) contains supplementary material, which is available to authorized users.
Highlights
Feedback has been a focus of the medical education literature for decades, covering a variety of features, techniques and purposes
Feedback is a central topic in medical education that has been deemed essential for helping learners to improve performance and meet standards of competency
Our analysis describes the state of the medical education literature on the topic of feedback to medical learners and its association with characteristics of improved patient care and provides a description of areas in need of further investigation
Summary
Feedback has been a focus of the medical education literature for decades, covering a variety of features, techniques and purposes. Many definitions of feedback exist in the literature, most focusing on behavioural change and performance improvement. A systematic review of feedback definitions in the medical literature by Van der Ridder [7] yielded the following compilation: “Feedback in clinical education is specific information about the comparison between a trainee’s observed performance and a standard, given with the intent to improve the trainee’s performance”. Is the focus of feedback as a means to effecting behavioural change enough? As recognized by Ende in his 1983 sentinel article on the use of feedback in medical education, “The goal of clinical training is expertise in the care of patients” [8]. Should there be a more robust feedback end goal of improved patient care and outcomes?
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