Moving the mean with feedback: insights from behavioural science.

Jeffrey A Linder

doi:10.1038/npjpcrm.2016.18

Abstract

Moving the mean with feedback: insights from behavioural science.

Highlights

Kahneman saw a teaching opportunity. He drew a chalk target on the floor, had the officers turn their backs to the target and try to hit the target with two successive no-look coin throws. Those familiar with regression to the mean can guess what happened: officers who were far from the target on their first throw generally improved on the second throw; officers who were close to the target on their first throw generally did worse on their second throw
My primary care group received feedback about our ordering of high-cost imaging for low-back pain. Such feedback might change the behaviour of doctors who order too many high-cost imaging tests, it can result in a ‘boomerang effect’ among doctors who order very few.[2]
The intervention consisted of advice in the family physicians’ electronic prescribing system, communication skills training and, 3 months after the communication skills training, a one-time feedback session about the group’s antibiotic prescribing rate. Antibiotic prescribing in both the control and intervention groups decreased, and there was no overall effect of the intervention

Summary

Introduction

My primary care group received feedback about our ordering of high-cost imaging for low-back pain. This may be part of the reason that feedback has not been shown to be effective in reducing imaging for low-back pain.[3] Variability decreases—poor performers improve and top performers worsen—but the mean does not move.

Results

Conclusion