Consultative Capacity Research Articles

New technology and working methods to improve healthcare for suspected malignant skin lesions: Implementation of teledermatoscopy in comprehensive healthcare

AbstractBackgroundSuspected malignant skin lesions are common and challenging in terms of diagnostic accuracy and lead time. Efficient use of teledermatoscopy has the potential to improve these factors.ObjectivesThis report aims to explore the implementation of teledermatoscopy for quality improvement in a comprehensive healthcare system.MethodsA stepwise implementation started in 2012 in the Stockholm Region, Sweden, serving 2.4 million inhabitants across approximately 240 primary healthcare centres. The full‐scale implementation occurred from May 2021 to February 2023, utilising a double‐reading teledermatoscopy system. The RE‐AIM framework (reach, effectiveness, adoption, implementation, maintenance) guided the evaluation, including measures such as participant engagement, referrals, diagnoses, staff participation, and centres going on post‐implementation. Descriptive statistics were used.ResultsIn the full‐scale implementation period, 10,862 referrals were transmitted, with 17% recommended for biopsy or excision. Among these, 282 (15%) were confirmed melanomas and 516 (28%) non‐melanoma skin cancers. Challenges were observed during the stepwise phase, particularly in engaging primary healthcare and establishing dermatologic consultation capacity. However, all centres and 1263 primary care physicians participated in the fully scaled implementation. Challenges included contractual compliance, adopting a collective system perspective, effective management transition of referrals, cost allocation, and communication improvements. Six months post‐study, most centres used the system, with around 1500 monthly referrals.ConclusionsThe evaluation revealed the overall satisfactory performance of the teledermatoscopy system in terms of reach, effectiveness, adoption, implementation, and maintenance during the fully scaled phase. Results underscore the effectiveness of a stepwise implementation to successfully address contextual challenges. The findings emphasise the system's potential for a broader patient outreach. In conclusion, implementation of teledermatoscopy for quality improvement in a comprehensive healthcare system is an organisational challenge but has the potential to improve healthcare quality for suspected malignant skin lesions.

SCHOOL CONSULTATION MODEL IN VIETNAM

The school consultation model in Vietnam currently being implemented according to Circular No. 31/2017/TT-BGDDT effective from February 2, 2018, is the “Part-time teacher” model. The purpose of this exploratory study is to test the awareness of officials and teachers about the effectiveness of elements in the “part-time teacher” school consultation model in high schools in Ho Chi Minh City, Vietnam. The research sample was randomly selected from 4 high school heads and from teacher pedagogical training courses and management training classes, with 538 participants, of which teachers (69.0%), and managers (31.0%); in the study sample, there were (36.2%) participating in the school’s psychology team. Research subjects (28.6%) were trained in psychological consultation capacity by topic; (8.9%) training in psychological counseling capacity and granting training certificates; (5.4%) training for bachelor of psychology and master of psychology; (57.1%) had not studied through the psychological counseling competency program. The instrument’s validity and reliability were verified through the evaluation of Cronbach alpha analysis, and exploratory factor analysis (EFA). When analyzing the EFA factor, the results of the factors in the model have a positive correlation of 76.2% (R2 = 1.00), in the factors of personnel conducting consultations, policies for personnel participating in consultations, and policies for consulting personnel. Joining the school counseling team, the consultation process and the consultation room have not been paying attention.

Using Lean Six Sigma in a Private Hospital Setting to Reduce Trauma Orthopedic Patient Waiting Times and Associated Administrative and Consultant Caseload.

In Ireland, the extent of outpatient orthopedic waiting lists results in long waiting times for patients, delays in processing referrals, and variation in the consultant caseload. At the study site, the Define, Measure, Analyze, Improve, and Control (DMAIC) Lean Six Sigma framework was applied to evaluate sources of Non-Value-Added (NVA) activity in the process of registering and triaging patients referred to the trauma orthopedic service from the Emergency Department. A pre- (October-December 2021)/post- (April-August 2022) intervention design was employed, utilizing Gemba, Process Mapping, and the TIMWOODS tool. Embracing a person-centered approach, stakeholder Voice of Customer feedback was sought at each stage of the improvement process. Following data collection and analysis, a co-designed pilot intervention (March 2022) was implemented, consisting of a new triage template, dedicated trauma clinic slots, a consultant triage roster, and a new option to refer directly to physiotherapy services. This resulted in the total wait time of patients for review being reduced by 34%, a 51% reduction in the process steps required for registering, and an increase in orthopedic consultant clinic capacity of 22%. The reduction in NVA activities in the process and the increase in management options for triaging consultants have delivered a more efficient trauma and orthopedic pathway.

Maryland’s infant and early childhood mental health consultation equity efforts

ABSTRACT Infant and early childhood mental health consultation (IECMHC) is a national model with proven positive outcomes for children, teachers and classrooms, as well as effectively addressing racial inequity in preschool suspension and expulsion rates. This paper discusses recent efforts in the Maryland IECMHC program to deeply and systematically address equity and increase consultant capacity to understand and address racial inequity within early childhood settings.

Enablers of incorporating indoor environmental quality (IEQ) principles into buildings

PurposeThe aim of this study was to identify these enablers in literature and subsume them under broad categories for the development of a framework showing the interrelationships among the enablers.Design/methodology/approachFifty-four (54) relevant articles were desk reviewed from different construction peer-reviewed journals and published conference proceedings to identify 20 core enablers of incorporating indoor environmental quality (IEQ) into building designs.FindingsThe identified enablers include improved occupants' health, well-being and satisfaction, environmental conservation, high return on investments and co-operative methods of design and construction management among others. To better understand the enablers identified, they were classified into seven main interconnected categories: economic enablers, environmental enablers, occupant and end-user enablers, process enablers, corporate image, culture and vision enablers, client-related enablers and external enablers.Research limitations/implicationsThe interconnectedness brought to the fore a subtler appreciation of the drivers of IEQ, which could help expand current knowledge outside the narrow scope of isolated drivers. The fact that the papers selected in this study are not limited geographically underscores the wide applicability of the findings to the global construction industry.Practical implicationsUnderstanding that the enablers will enhance the adoption and design of quality indoor environments, help in building the capacity of consultants to adopt the design of quality IEs and reduce the impact of construction on the environment.Social implicationsThese identified enablers are not limited geographically and thus could promote the design of quality indoor environments globally, particularly in green building design. To the global construction community, this review presents a list of enablers that would expedite the adoption of principles of IEQ designs in buildings thus taking the global construction industry one more step towards sustainable built forms. Promoting the identified enablers would ultimately steer stakeholders to design and build better indoor environments.Originality/valueThe fact that the papers selected in this study are not limited geographically underscores the wide applicability of the findings to the global construction industry.

A survey of speech pathologist practice patterns for consulting registered dieticians when recommending diet alterations

ABSTRACT Introduction: Diet modification in dysphagia management can significantly impact patient nutrition and hydration status. Since speech-language pathologists (SLPs) do not receive formal training in nutrition, consulting Registered Dieticians (RDs) to assist in diet recommendations is important for patient wellness. The study aimed to better understand current SLP practice patterns for consulting RDs and investigate how work setting, years of experience, education, and patient diagnosis may influence decisions. Methods: A six-item survey was provided to practicing SLPs via a web-based format. Descriptive statistics were used to describe trends in the frequency of RD consultation. Logistic regression was used to identify demographics or educational factors that showed statistically significant higher odds for consulting an RD. Results: 359 SLPs completed the entire survey. Thirty-nine percent of all SLPs and 40% of acute care SLPs indicated they have never or rarely (< 10% of the time) consult an RD prior to making a diet recommendation. Work setting and years of experience did not significantly impact the frequency of RD consults. However, those who had previously taken a course on the impact of diet modifications were 2.4 times more likely to consult an RD (p < 0.001). Conclusion: Since the majority (82%) of participants reported working in an inpatient setting and regulations require, at a minimum, access to an RD in a consultative capacity, the low percentage of consultations indicates an underutilization of a valuable resource. Increased educational opportunities that emphasize the impact of modiying diets may increase RD consultations and team-based decision-making to positively impact overall patient health.

Defining the Scope of Knowledge Translation Within a National, Patient-Oriented Kidney Research Network.

Purpose of program:Integrated knowledge translation (IKT) is a collaborative approach whereby knowledge created through health research is utilized in ways that are relevant to the needs of all stakeholders. However, research teams have limited capacity and know-how for achieving IKT, resulting in a disconnect between the generation and application of knowledge. The goal of this report is to describe how IKT research was achieved across a large-scale, patient-oriented research network, Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD).Sources of information:Resources to facilitate knowledge translation (KT) planning across the network were developed by the Can-SOLVE CKD Knowledge User/Knowledge Translation Committee with reference to established Canadian KT and patient engagement tools and frameworks, review of the published and gray literature, and expertise of committee members.Methods:The Can-SOLVE CKD Knowledge User/Knowledge Translation Committee consisting of patient partners, health care providers, policymakers, and researchers provided oversight of the development and implementation of the network’s IKT initiatives. Guided by its strategic framework, the committee developed KT planning templates and review checklists to assist network projects with preparing for dissemination, implementation, and scale and spread of their interventions. The committee has acted in a consultative capacity to facilitate IKT across network initiatives and has supported capacity building through KT activities aimed at network membership and knowledge users more broadly.Key findings:The Can-SOLVE CKD Knowledge User/Knowledge Translation Committee established a nation-wide strategy for KT infrastructure and capacity building. Acting as a knowledge intermediary, the committee has connected research teams with knowledge users across Canada to support practices and policies informed by evidence generated by the network. The committee has developed KT initiatives, including a Community of Practice, whereby participants across different regions and disciplines convene regularly to share health research knowledge and communications strategies relevant to the network. Critically, patients are engaged and contribute throughout the research process. Examples of IKT activities from select projects are provided, as well as ways for sustaining the network’s KT platform.Limitations:The KT resources developed by the committee were adapted from other established resources to meet the needs of the network and have not undergone formal evaluation in this context. Given the broad scope of the network, resources to facilitate implementation and knowledge user engagement may not meet the needs of all initiatives and must be tailored accordingly. Knowledge barriers, including a lack of information and skills related to conceptual and practical aspects of KT, among network members provided a rationale for various KT capacity–building initiatives.Implications:The approach described here offers a practical method for achieving IKT, including how to plan, implement, and sustain initiatives across large-scale health research networks. Within the context of Can-SOLVE CKD, these efforts will shorten knowledge-practice gaps through producing and applying relevant research to improve the lives of people living with kidney disease.

A system dynamics approach to conceptualise causes of cost overrun of construction projects in developing countries

PurposeThis study aimed at developing and empirically testing a system dynamics causal loop (SDCL) model for investigating factors related to the risk of cost overruns, associated with the performance of construction projects in developing countries.Design/methodology/approachUsing data derived from the Ghanaian construction industry (GCI), a conceptual system dynamics model was hypothesised and empirically tested.FindingsSupported by empirical evidence, the study established that the low technical capacity of consultants is the underlying cause of cost overruns in government projects. There is a strong proof of the relationship between the results of the SDCL model and poor contract planning and supervision, change orders, competence of the project team and the lack of effective coordination amongst the contractual parties.Practical implicationsThe final SDCL model has revealed key risk components that would require standard mitigation measures in order to achieve “acceptable success” in construction projects.Originality/valueThe study presents an interactive approach for construction practitioners in developing countries to prioritise the causes of cost overruns in order to initiate quick responses.

Implementation of a Centralized Telepsychiatry Consult Service in a Multi-Hospital Metropolitan Health Care System: Challenges and Opportunities.

BackgroundProviding adequate psychiatry consultation capacity on a 24/7 basis is an intrinsic challenge throughout many multihospital health care systems. At present, implementation research has not adequately defined the effectiveness and feasibility of a centralized telepsychiatry consultation service within a multihospital health care system.ObjectiveTo demonstrate feasibility of a hub and spoke model for provision of inpatient consult telepsychiatry service from an academic medical center to 2 affiliated regional hospital sites, to reduce patient wait time, and to develop best practice guidelines for telepsychiatry consultations to the acutely medically ill.MethodsThe implementation, interprofessional workflow, process of triage, and provider satisfaction were described from the first 13 months of the service.ResultsThis pilot study resulted in 557 completed telepsychiatry consults over the course of 13 months from 2018 to 2019. A range of psychiatric conditions commonly encountered by consultation-liaison services were diagnosed and treated through the teleconferencing modality. The most common barriers to successful use of telepsychiatry were defined for the 20% of consult requests that were retriaged to face-to-face evaluation. The average patient wait time from consult request to initial consultation was reduced from >24 hours to 92 minutes.ConclusionsThis study demonstrated the feasibility of a centralized telepsychiatry hub to improve delivery of psychiatry consultation within a multihospital system with an overall reduction in patient wait time. This work may serve as a model for further design innovation across many health care settings and new patient subpopulations.

Causal Effect of Honorary Titles on Physicians' Service Volumes in Online Health Communities: Retrospective Study.

BackgroundAn OHC online health community (OHC) is an interactive platform for virtual communication between patients and physicians. Patients can typically search, seek, and share their experience and rate physicians, who may be involved in giving advice. Some OHC providers provide incentives in form of honorary titles to encourage the web-based involvement of physicians, but it is unclear whether the award of honorary titles has an impact on their consultation volume in an OHC.ObjectiveThis study is designed to identify the differential treatment effect of the incentive policy on the service volumes for the subgroups of treatment and control in an OHC. This study aims to answer the following questions: Does an honorary title for physicians impact their service volumes in an OHC? During the period of discontinuity, can we identify the sharp effect of the incentive award on the outcomes of physicians’ service volumes?MethodsWe acquired the targeted samples based on treatment, namely, physicians with an honorary title or not and outcomes measured before and after the award of the 2 subgroups. A regression discontinuity design was applied to investigate the impact of the honorary titles incentive as a treatment in an OHC. There was a sharply discontinuous effect of treatment on physicians’ online health service performance. The experimental data set consisted of 346 physicians in the treatment group (with honorary titles). Applying the propensity score matching method, the same size of physicians (n=346) was matched and selected as the control group.ResultsA sharp discontinuity was found at the time of the physician receiving the honorary title. The results showed that the parametric estimates of the coefficient were significantly positively (P<.001) associated with monthly home page views. The jump in the monthly volumes of home page views was much sharper than that of the monthly consultations.ConclusionsThe changes in the volumes of monthly consultations and home page views reflect the differential treatment effect of honorary titles on physicians’ service volumes. The effect of the incentive policy with honorary titles is objectively estimated from both the perspective of online and offline medical services in an OHC. Being named with honorary titles significantly multiplied monthly home page views, yet it did not significantly impact monthly consultations. This may be because consultation capacity is limited by the physician's schedule for consultations.

Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital

BackgroundValue-based healthcare (VBHC) is a promising strategy to increase patient value. For a successful implementation of VBHC, intensive collaborations between organizations and integrated care delivery systems are key conditions. Our aim was to evaluate the effects of a pilot study regarding enhancing regional integration between a cardiac centre and a referring hospital on patient-relevant clinical outcomes and patient satisfaction.MethodsThe study population consisted of a sample of patients treated for coronary artery disease by use of a coronary artery bypass graft (CABG) or a percutaneous coronary intervention between 2011 and 2016. Since 2013, the two hospitals have implemented different interventions to improve clinical outcomes and the degree of patient satisfaction, e.g. improvement of communication, increased consultant capacity, introduction of outpatient clinic for complex patients, and improved guideline adherence. To identify intervention effects, logistic regression analyses were conducted. Patients’ initial conditions, like demographics and health status, were included in the model as predictors. Clinical data extracted from the electronic health records and the hospitals’ cardiac databases as well as survey-based data were used.ResultsOur findings indicate a non-significant increase of event-free survival of patients treated for coronary artery disease between 2014 and 2016 compared to patients treated between 2011 and 2013 (97.4% vs. 96.7% respectively). This non-significant improvement over time has led to significant better outcomes for patients referred from the study referring hospital compared to patients referred from other hospitals. The level of patient satisfaction (response rate 32.2%; 216 out of 669) was improved and reached statistically significant higher scores regarding patient information and education (p = .013), quality of care (p = .007), hospital admission and stay (p = .032), personal contact with the physician (p = .024), and total impression (p = .007).ConclusionsThis study shows a promising effect of regional integration. An intensified collaboration in the care chain, organized in a structured manner between a cardiac centre and a referring hospital and aiming at high quality, resulted in successful improvement of clinical outcomes and degree of patient satisfaction. The applied method may be used as a starting point of regional integration with other referring hospitals. We encourage others to organize the whole care chain to continuously improve patient-relevant outcomes and patient satisfaction.Trial registrationISRCTN11311830. Registered 01 October 2018 (retrospectively registered).

Clinical practice and teaching of pharmaceutical care procedures for obstetric diseases

ObjectivesOur goal was to explore the pharmaceutical service and teaching methods of obstetric clinical pharmacists to establish standardised pharmaceutical care procedures for obstetric diseases.MethodsAccording to the evidence-based medicine method, the...

A Study on the Influence of Consultant Capacity on Consulting Utilization and Social Network: Focused on Moderating Effect of Gender

Background/Objectives: This study will identify social networks and consultant capacity concepts to verify that social networks are important factors and study whether consultant capacity and social networks influence consulting use.Methods/Statistical analysis: The subjects of the study can be companies that have consulted consulting services of SMBs, and the samples were analyzed by conducting a questionnaire survey on more than 240 SMBs that have consulted consulting services in Korea. The survey consisted of 30 questions including 10 demographic items, and Likert 5-point scale was used. In the empirical analysis, descriptive analysis, exploratory factor analysis, confirmatory factor analysis, structural model analysis, and adjustment effect test were analyzed by AMOS 22.0 using SPSS 22.0.Findings: Studies have shown that first, the knowledge of consultants was shown to have a positive effect on the social network. Second, the ability of consultants was found to have a positive effect on social networks. Third, the attitude of consultants was found to have a positive effect on social networks. It is analyzed that the attitude of the consultant is expressed in personal feelings and that a strong network can be formed through a sincere attitude. Fourth, social networks have been found to have a positive effect on consultancy utilization. It means that the utilization of consulting can be improved through the formation of an active social network. Fifth, analyzing the differences in the path between the gender, it was found to be affected by the Moderating effect. In the case of men, consultant knowledge and attitudes have derived positive results in social networks and consulting use. And in the case of women, the ability of consultants became more active in consulting with social networks. Therefore, the difference in the effect between male and female was confirmed statistically.Improvements/Applications: In this study, it was confirmed that there was a difference between men and women when the consultant's ability affected the consulting utilization rate. Therefore, it is necessary to conduct a detailed study of measures to supplement the gender gap in the competence of consultants in SMB consulting.

Challenges in developing the Ethiopian construction industry

To ensure continual improvement in the construction industry’s performance, its challenges must be identified so that integrated solutions that suit the context can be provided. The Ethiopian construction industry, like that in most developing countries, faces challenges that impede its development. This paper assesses four categories of challenges facing the industry, based on their sources: variables emanating from role of government, resource related variables, those related to the nature of the industry and variables emanating from the vision of the industry itself for its own development. Data for the study were collected through a questionnaire survey. Professionals from different background, such as contractors, consultants, clients, regulatory authority and academics were engaged in the survey. Mean score was used to identify the perceived impact level of the variables. Significant variables were identified and factor analysis was conducted to identify the underlying dimensions of the different sources. The major challenges are identified as: (i) delay in construction industry development (CID) policy implementation and corruption; (ii) weak capacity of contractors and consultants; (iii) lack of collaboration and professionalism; and (iv) lack of benchmarking CID practice from role of government, resource related variables, nature of the industry and industry’s vision for its own development, respectively. Findings provide information that stakeholders can use to make informed decisions and critical interventions for the effective development of the industry.

Leveraging Effective Consulting to Advance Diversity, Equity, and Inclusion in Philanthropy

In 2018, the National Network of Consultants to Grantmakers launched an initiative to sharpen the impact of diversity, equity, and inclusion (DEI) work in grantmaking by increasing the capacity of consultants and grantmakers engaged in these efforts. Network researchers used a systematic protocol to interview consultant members about their most effective partnerships with grantmakers. Case studies drawn from those interviews yielded valuable lessons for advancing DEI in philanthropy.

The Virtual Hospital

To provide virtual triage and, where appropriate, virtual coordination of investigations and care of gastroenterology general practitioner (GP) referrals. A bespoke secure platform was created to receive gastroenterology referrals from GPs from Barking, Redbridge and Havering clinical commissioning groups. Any gastroenterology referral was accepted, excluding urgent or 2-week wait referrals. To support local consultant capacity, we adopted a unique approach by recruiting NHS gastroenterology consultants from around the country. They were …

Development of an instrument to assess clinical reasoning

Teaching clinical reasoning is a challenge in medical education. To design a clinical reasoning assessment instrument. Structured interviews were carried out to six physicians with at least five years experience. The Grounded Theory method was used to determine the relevant categories of the clinical reasoning process and the modified Delphi expert judgment method to validate the categories, the definition of observable behaviors and the format of the instrument. The relevant reasoning categories were the reason for consultation, medical history, physical examination, additional tests, diagnosis, therapeutic options and reasoning reassessment capacity. Expert judgment assessed at a level of "strongly agree" and "agree" the sufficiency, clarity and pertinence of all categories, related observable behaviors and instrument format. The internal Kappa consistency yielded an index of 0.92. The resulting instrument was constructed with the following axes derived from the main categories and subcategories: reason for consultation, history, physical examination, additional tests, diagnosis, therapeutic options and reassessment capacity.

The view of a general practitioner on immediate access for patients to their laboratory test results.

This position paper presents the role of laboratory test results in traditional general practice and provides a recommendation for responsible sharing of results with patients for improved safety, efficiency and outcomes. This paper looks at the relationship between the laboratory, the general practitioner consultation, the patient, safety and general practice capacity. We suggest changes in the traditional practice of communicating laboratory test results whereby normal or abnormal results are made available to patients as soon as they become available. We also endorse the opinion that using online tools such as email or text messages could enhance the provision of rapid access to laboratory test results for patients.

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OBJECTIVES/SPECIFIC AIMS: Engaging Richmond is a community-university partnership, made up of local residents and university faculty and staff that was established in 2011 with an NIH supplement to a Clinical and Translational Science Research Award at Virginia Commonwealth University (VCU). The primary aims of the supplement were to (1) to conduct community-based participatory research (CBPR) on the leading causes of health disparities perceived by the Richmond community and (2) to thereby highlight community needs and assets and build capacity for future community-engaged research (CEnR). The goal was to prepare a community-focused, community-prioritized, health equity report while building capacity, strengthening relationships, and discovering local barriers to CEnR, and therefore to stimulate, facilitate, and inform future CEnR at VCU. METHODS/STUDY POPULATION: This is a case study exploring the impact of 1 community-university partnership on investigator-initiated research using historical and qualitative data. RESULTS/ANTICIPATED RESULTS: Although Engaging Richmond received only 12 months of support from the NIH supplement that provided its initial funding, the community-university partnership has worked continuously since its formation in 2011. This work has not only helped to build connections with the community and key stakeholders, it has also contributed substantially to the resources available to university faculty pursuing CEnR. Specifically, we find that Engaging Richmond has contributed to investigator initiated research in the following ways, either working as co-investigators or in a consultative capacity: consultation on proposal development (5 projects); assisted with instrument development (4 projects); participant recruitment (7 projects); data collection and analysis (6 projects); dissemination (5 projects). In addition to collaboration on projects, Engaging Richmond has increased institutional capacity for CEnR through its contributions to the Annual Community Engaged Institute at the university and the Center of Clinical and Translational Science’s Community Review Board (CRB). The CRB helps researchers work successfully in a community setting, enhance the research design, help to improve study implementation and assist with translation and dissemination of findings. DISCUSSION/SIGNIFICANCE OF IMPACT: Although community-university partnerships have become much more common over the past several decades, there remains a gap in research evidence on the impact of these partnerships. In their 2004 review, Viswanathan et al. note that community-based participatory research studies infrequently document improved capacity of researchers and research organizations as an outcome, despite the expectation that such improvement will accrue through investment in CEnR. A more recent study assessing the range of community-university partnerships across a research university also noted the lack of processes in place to assess impacts (Holton et al., 2015). While assessments of CEnR impact on communities have become increasingly common as demand for evidence about the effectiveness of community-engaged partnerships has mounted, there does not appear to be a similar trend in assessing the impact of these efforts on faculty research and institutional capacity. By focusing on the impact of 1 community-university partnership that has been sustained for over 5 years, we highlight the ways in which having ongoing partnerships in place can support and strengthen investigator-initiated research, reflecting the flexible, “2-way approach” (Weerts and Sandmann, 2010) at the heart of CEnR.

Effects of demographic factors on provision of feedback in postgraduate medical education

A key element in the process of clinical medical education is the process of providing feedback by comparing the directly observed performance of postgraduate doctors training to become specialists to that of a previously identified and communicated ‘gold standard’ and incorporating a plan for improvement. This is regarded as crucial to enhance clinical competencies. Hence, a greater understanding of the clinical educational environment and the various factors that impact on the giving and receiving of feedback within such a setting is required. A mixed methods approach was adopted for this observational study regarding the perceptions of the quality of feedback given and received at a large multicultural teaching hospital. Relationships between demographics and certain important aspects of the provision of feedback were observed which impact on the context in which feedback is given and received. The study found that appropriate strategies should be implemented to improve teaching capacity of consultants, together with gender empowerment and academic support programmes for registrars.