Free-text Feedback Research Articles

Implementation of Entrustable Professional Activities into a General Surgery Residency

Concerns over resident ability to practice effectively after graduation have led to the competency-based medical education movement. Entrustable professional activities (EPAs) may facilitate competency-based medical education in surgery, but implementation is challenging. This manuscript describes 1 strategy used to implement EPAs into an academic general surgery residency. A mobile application was developed incorporating 5 EPAs developed by the American Board of Surgery; residents and faculty from the Departments of Surgery, Emergency Medicine, and Hospital Medicine at a single tertiary care center were trained in its use. Entrustment levels and free text feedback were collected. Self-assessment was paired with supervisor assessment, and faculty assessments were used to inform clinical competency committee entrustment decisions. Feedback was regularly solicited from app users and results distributed on a monthly basis. One thousand seven hundred and twenty microassessments were collected over the first 16 months of implementation; 898 (47.8%) were performed by faculty with 569 (66.0%) matched pairs. Engagement was skewed with small numbers of high performers in both resident and faculty groups. Continued development of resident and faculty was required to sustain engagement with the program. Nonsurgical specialties contributed significantly to resident assessments (496, 28.8%). EPAs are being successfully integrated into the assessment framework at our institution. EPA implementation in surgery residency is a long-term process that requires investment, but may address limitations in the current assessment framework.

Medical training in palliative care at the Hannover Medical School: development of the interdisciplinary and cross-sectoral education in the cross-sectional subject Q13 (WEISE-Q13)

The implementation of the cross-sectional subject of palliative care (Q13) at medical faculties in Germany is heterogeneous. In faculties without achair for palliative medicine, other solutions are needed. This study describes the development and implementation process of the new educational concept in Q13 at the Hannover Medical School and its evaluation by medical students and lecturers. The new educational concept was developed in 2017/18 following the six-step approach of curriculum development by Kern, and was implemented and tested in the academic year 2018/19. Evaluation was assessed in two steps, both in qualitative and quantitative terms (mixed methods): an anonymous written evaluation by students with the option of free text answers and feedback discussions with lecturers. Students and lecturers welcomed the new educational concept in equal measures. Students thought that education in Q13 stimulates reflection on the individual attitude towards the issues of death and dying and prepares them for encounters with terminally ill and dying people. The case-based learning units in particular led to aconsolidation of theoretical knowledge (i.e. pain management) with adequate patient orientation. Teachers positively highlighted the organization and the educational material. Content structuring was considered to be particularly helpful. With the new teaching concept, medical students feel well prepared for the treatment of terminally ill and dying patients. The combination of different learning formats with an interdisciplinary and cross-sectoral focus promotes education with apractical orientation.

\u2018We\u2019re here to listen and help them as well\u2019: a qualitative study of staff and Indigenous patient perceptions about participating in social and emotional wellbeing research at primary healthcare services

BackgroundResearch can inform culturally-appropriate care to strengthen social and emotional wellbeing (SEWB) among Aboriginal and Torres Strait Islander (hereafter, the term ‘Indigenous Peoples’ is respectfully used and refers to all Aboriginal and/or Torres Strait Islander Peoples of Australia). We acknowledge the cultural diversity of Australia’s Indigenous First Peoples and they do not represent a homogenous group.) (hereafter Indigenous) Peoples. We explore the perspectives of primary healthcare staff and Indigenous patients about their willingness to and experiences participating in SEWB research.MethodProcess evaluation using grounded theory approaches of Getting it Right: The validation study, a national validation designed Indigenous SEWB research project (N = 500). Primary healthcare staff (n = 36) and community members (n = 4) from nine of ten primary healthcare services involved with the research project completed qualitative semi-structured interviews. Interview data were triangulated with participant feedback (responses to structured questions and free-text feedback collected during Getting it Right), study administrative data (participant screening logs, communication logs, study protocol, deviation logs and ethics correspondence) and interviewer field notes.ResultsThree themes about staff, patient and community perspectives concerning research participation developed: (1) considering the needs, risk, preferences and impact of participation in research for staff, patients and community; (2) building staff confidence speaking to patients about research and SEWB problems and (3) patients speaking openly about their SEWB. Some staff described pressure to ensure patients had a positive experience with the research, to respond appropriately if patients became upset or SEWB problems were identified during interviews, or due to their dual role as community member and researcher. Patients and staff reported that patients were more likely to participate if they knew the staff outside of the service, especially staff with a shared cultural background, and they perceived SEWB as a community priority. Staff reported their skills speaking to patients about the research and SEWB improved during the research, which built their confidence. Contrary to staff preconceptions, staff and patients reported that many patients appreciated the opportunity to speak about their SEWB and contributing to research that may eventually enhance SEWB in their community.ConclusionOur research project was considered acceptable by most staff and patients. The positive outcomes reported by staff and feedback from patients highlights the importance of providing opportunities for people to speak about their SEWB and for research-informed SEWB PHC care.Trial registrationGetting it Right is registered on ANZCTR12614000705684.

Flipped learning: Turning medical education upside down

Flipped learning is an approach in which core teaching is delivered using online material viewed prior to face-to-face learning, applying knowledge gained from online material. Core teaching in a module for third-year undergraduate medical students was based around a 1-week course comprising 32 hours of lectures. Feedback suggested that students were poorly engaged and attendance was poor. To develop and evaluate a programme of learning for medical students using flipped learning. Core lectures were videoed and students were advised to watch online at home in the morning prior to a case-based interactive discussion session in the afternoon. Feedback was undertaken prior to and following change in delivery; changes in Likert scale feedback were assessed. Thematic assessment of free-text feedback was undertaken. Results of in-course assessment examinations were compared prior to and following change in delivery. Student feedback showed a significant improvement in satisfaction with flipped learning compared to standard lectures, both in scores and free-text feedback. Results of in-course assessments did not change between the two methods of delivery. Flipped learning can improve student satisfaction and engagement with teaching, but our study has not demonstrated an improvement in assessment scores.

The Application of Sentiment Analysis and Text Analytics to Customer Experience Reviews to Understand What Customers Are Really Saying

In a world of ever-growing customer data, businesses are required to have a clear line of sight into what their customers think about the business, its products, people and how it treats them. Insight into these critical areas for a business will aid in the development of a robust customer experience strategy and in turn drive loyalty and recommendations to others by their customers. It is key for business to access and mine their customer data to drive a modern customer experience. This article investigates the use of a text mining approach to aid sentiment analysis in the pursuit of understanding what customers are saying about products, services and interactions with a business. This is commonly known as Voice of the Customer (VOC) data and it is key to unlocking customer sentiment. The authors analyse the relationship between unstructured customer sentiment in the form of verbatim feedback and structured data in the form of user review ratings or satisfaction ratings to explore the question of whether customers say what they really think when given the opportunity to provide free text feedback as opposed to how they rate a product on a scale of one to five. Using various Sentiment Analysis approaches, the authors assign a sentiment score to a piece of verbatim feedback and then categorise it as positive, negative, or neutral. Using this normalised sentiment score, they compare it to the corresponding rating score and investigate the potential business insights. The results obtained indicate that a business cannot rely solely on a standalone single metric as a source of truth regarding customer experience. There is a significant difference between the customer ratings score and the sentiment of their corresponding review of the product. The authors propose that it is imperative that a business supplements their customer feedback scores with a robust sentiment analysis strategy.

Process evaluation of the Getting it Right study and acceptability and feasibility of screening for depression with the aPHQ-9

BackgroundThe Getting it Right study determined the validity, sensitivity, specificity and acceptability of the culturally adapted 9-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) people. In this process evaluation we aimed to explore staff perceptions about whether Getting it Right was conducted per protocol, and if the aPHQ-9 was considered an acceptable and feasible screening tool for depression in primary healthcare. This process evaluation will provide information for clinicians and policy makers about the experiences of staff and patients with Getting it Right and what they thought about using the aPHQ-9.MethodsProcess evaluation using grounded theory approaches. Semi-structured interviews with primary healthcare staff from services participating in Getting it Right were triangulated with feedback (free-text and elicited) from participants collected during the validation study and field notes. Data were thematically analysed according to the Getting it Right study protocol to identify the acceptability and feasibility of the aPHQ-9.ResultsPrimary healthcare staff (n = 36) and community members (n = 4) from nine of the ten participating Getting it Right services and Indigenous participants (n = 500) from the ten services that took part. Most staff reported that the research was conducted according to the study protocol. Staff from two services reported sometimes recruiting opportunistically (rather than recruiting consecutive patients attending the service as outlined in the main study protocol), when they spoke to patients who they knew from previous interactions, because they perceived their previous relationship may increase the likelihood of patients participating. All Getting it Right participants responded to at least six of the seven feedback questions and 20% provided free-text feedback. Most staff said they would use the aPHQ-9 and most participants said that the questions were easy to understand (87%), the response categories made sense (89%) and that they felt comfortable answering the questions (91%).ConclusionGetting it Right was predominantly conducted according to the study protocol. The aPHQ-9, the first culturally adapted, nationally validated, freely available depression screening tool for use by Indigenous people, appears to be acceptable and feasible to use.Trial registrationAustralian New Zealand Clinical Trial Registry ANZCTR12614000705684, 03/07/2014.

Trauma-informed primary care for medical residents.

Psychological trauma can have a significant impact on mental and physical health, and interpersonal relationships. Many physicians report discomfort addressing psychological trauma in the context of health care visits, and few training opportunities exist for health care trainees to learn about the relationship between trauma and health. The aim of this project was to develop and implement an educational curriculum to teach medical and nursing trainees about trauma-informed primary care. We expanded upon pilot data from a brief interdisciplinary intervention to train medical residents in trauma-informed primary care at a Veterans Affairs hospital. We generated a trauma-informed care curriculum involving five 1-hour didactic sessions, 10-minute group reflection regarding patient interactions prior to each didactic session, and optional patient care observation and feedback. The curriculum aligned with internal medicine (n=16) and nurse practitioner (n=5) interprofessional primary care education sessions during the 2017/18 academic year. The curriculum was feasible and associated with increased self-reported knowledge, attitudes and practice around trauma-informed care. Free text feedback indicated that residents found the topic important, appreciated a skills-based approach and valued experiential educational activities. Training residents in trauma-informed care results in improved knowledge, attitudes and practices in caring for patients with psychological trauma. Residents appreciated both experiential and skills-based exercises. Next steps include continued exploration of using direct observation and feedback, and examining effects of training on patient outcomes (e.g. satisfaction with care).

Evaluation of a Structured Onboarding Process and Tool for Faculty Members in a School of Pharmacy

Objective. To develop and assess the usefulness of a structured onboarding process and tool at a school of pharmacy to improve the overall onboarding experience for new faculty members. Methods. An assessment of a previously existing, informal onboarding process was conducted from January 1 to February 28, 2017. A structured onboarding tool was developed based on interviews with nine recently hired faculty members regarding their experiences with this legacy, unstructured onboarding process. Nine faculty members who onboarded while the legacy onboarding process was in place and six faculty members who onboarded after the new, onboarding tool was in place were included in the study. The experience of the pre-tool cohort was compared to that of the post-tool cohort. Results. More positive responses in the post-tool cohort were obtained compared to the pre-tool cohort in regard to timeline, expectations, and mentorship. More negative responses for the post-tool group were observed for communication. Overall utility of the onboarding tool changed from 56% (pre-tool group) to 80% (post-tool group). Free text feedback included recommendations to rearrange tasks throughout the onboarding process; clarifying mentor responsibilities and expectations; and providing an overview of the checklist to new faculty members on day 1. Conclusion. Overall, a structured onboarding process tool improved the onboarding experience for new faculty members. Given the lack of literature regarding a structured onboarding process in the academic setting, further refinement and analysis of the onboarding tool is needed.

Preparing for influenza outbreaks: the role of online educational resources

This article was migrated. The article was not marked as recommended. Introduction Influenza is a serious disease that can cause considerable morbidity and mortality. It results in regular seasonal outbreaks and occasionally in global pandemics. Healthcare professionals must learn about influenza (both pandemic and seasonal varieties) - however sometimes this disease can cause particular challenges to healthcare professional educators. E-learning modules may be an effective means of educating healthcare professionals on this subject.Methods BMJ Learning has published a series of modules on influenza - including seasonal and pandemic influenza. The goals of the modules were to help healthcare professionals learn about the assessment, diagnosis, differential diagnosis, and management of both seasonal and pandemic influenza. All healthcare professional users who completed the modules were encouraged to give free text feedback on the modules. We evaluated the modules by analysing this feedback from aqualitative perspective.Results Feedback to the modules was positive. Users appreciate the concise, case based and real-life nature of the modules. However, users expect the technology to be reliable and appreciate content in different formats - including text, audio and video. Some users had ongoing clinical learning needs - related to details on the diagnosis, differential diagnosis, and complications of influenza. Conclusions There have been hypotheses in the past that e-learning modules could play an important role in infectious disease outbreaks. This paper suggests that they do have a role. To maximise their effectiveness it is likely that modules need to be concise, case based and in a variety of different formats.

A new approach to OSCE preparation - PrOSCEs

BackgroundObjectively structured clinical examinations (OSCEs) are a stressful experience for many health care students and professionals in training. Mock OSCEs have been shown to be beneficial for student OSCE preparation. However, due to their expense and administrative burden students may only get a few opportunities to partake in these. To address this gap in student preparation a series of regularly run totally peer led multi-role practice OSCEs (PrOSCEs) was developed.MethodsFifteen PrOSCEs were run over five-months. A total of 32 second year medical students took part, all of whom were enrolled on the graduate-entry programme at the University of Southampton. In each PrOSCE, 18 participants rotated through the roles of ‘student’, ‘examiner’ and ‘patient’ in six simulated stations designed by their peers. Peer feedback was provided after each station. At the end of the series of PrOSCEs students were asked to fill in an anonymous online feedback survey to assess the usefulness of the PrOSCEs in exam preparation.ResultsTwenty-two students responded to the survey. 100% of respondents deemed routine participation either ‘very useful’ or ‘useful’ in preparing for their exam. PrOSCEs were found to improve confidence (mean = 7.9/10, 95% CI 7.4–8.3), expected performance (mean = 7.5/10, 95% CI 6.8–8.2) and help guide revision (mean = 8.3/10, 95% CI 7.6–9.0). Self-perceived teaching performance and confidence in providing feedback was also positively associated with participation. The most beneficial roles were ‘student’ and ‘station creator’. Free-text feedback suggests that the informal setting and regular practice were particularly beneficial.ConclusionThe peer-led nature of the PrOSCEs allows for a low cost, low administrative burden and easy to replicate adjunct or alternative to large scale mock OSCEs. In addition the multi-role aspect of this approach could enhance exam preparation and may also improve aptitude as a clinical teacher. Further studies are required to understand if repeated practice has beneficial implications on OSCE performance.

Virtual reality videos used in undergraduate palliative and oncology medical teaching: results of a pilot study

BackgroundVirtual reality (VR) immersive environments have been shown to be effective in medical teaching. Our university hospital received funding from our deanery, Health Education in Wales, to film teaching videos...

Education Research: An arts-based curriculum for neurology residents.

To determine the feasibility and educational value of an arts-based curriculum for neurology residents, with the following specific learning objectives: to enhance communication and observational skills, increase awareness of point of view, and deepen appreciation of the narrative content of illness. Narrative medicine and visual thinking exercises, adopted from the study of literature and art history, were offered as monthly sessions in the neurology residents' conference schedule. Participants completed an institutional review board-approved anonymous evaluation using a 5-point Likert scale to rate course effectiveness and perform a retrospective pre- and post-self-assessment of communication and visual observation skills. They also provided free text feedback on the course. All participants rated the course highly and found the exercises effective in enhancing awareness of language and observational skills. Eighty percent of participants rated their listening and observation skills as above average after participation, which improved from 63% and 45%, respectively, before the sessions. Comments on the course cited the importance of reflection, focused attention, awareness of multiple perspectives, and appreciation of colleagues. Arts-based graduate medical education is feasible and effective in teaching residents to listen and observe more closely. Narrative medicine and visual thinking exercises highlight these skills and promote professional growth, providing an opportunity to reflect and find meaning in clinical work.

Animated stories of medical error as ameans of teaching undergraduates patient safety: an evaluation study.

BackgroundStorytelling is a powerful form of communication which can improve attention and lead to lasting behavioural changes. Addressing the need to incorporate patient safety teaching into undergraduate medical curricula, it was hypothesized that medical students could benefit from hearing clinician stories of medical error. The medium of animation was considered to be a potentially engaging means of presenting stories of error to a large audience.MethodsThree animated videos were developed to accompany audio recordings of junior doctors describing their experiences of a serious incident or near-miss event. The videos were delivered to 200 final-year medical students with a subsequent large-group discussion directed at understanding contributory factors. An evaluative questionnaire exploring learners’ reactions and modification of beliefs and perception was distributed. The questionnaire included questions rated on a modified Likert scale and a free-text box. A mixed-methods analysis was conducted with descriptive statistics and qualitative content analysis of the free-text responses.ResultsOf the 200 students who attended, 104 completed the questionnaire and 83 completed free-text feedback. Most students responded positively to hearing stories of medical error and felt that the animated videos improved their engagement while the voice recordings helped bring the cases to life. The majority of students agreed the session would impact on their future practice.ConclusionThis pilot study confirmed that undergraduate students consider animated, personal stories of medical error an effective, engaging means of learning about patient safety. Longitudinal studies are required to confirm if measurable behaviour change is achieved.

Is drawing a valuable skill in surgical practice? 100 surgeons weigh in

The author noted surgeons frequently drawing in routine practice. Literature review revealed no prior study of this activity. This research was conducted to examine the prevalence, purpose, and perceived value of this practice. Surgeons' experiences and opinions regarding drawing in surgical practice were canvassed via an online survey. One-hundred surgeons participated. 92% valued drawing routinely in practice. Utility was reported across domains of consent, communication, patient care, medico-legal, education, and planning operations. Free-text feedback is discussed, and learning points from this data were summarised. This paper establishes the collective professional opinion of 100 surgeons regarding the value of drawing, which plays a thriving role in current surgical practice. The utility of this skill transcends merely documenting visual information, allowing surgeons to quickly visualise simplified, dynamic representations of reality. This facilitates communication between professionals, and with their patients. The efficiency and availability of this medium allows drawing to maintain a distinct role in medical communication amongst other imaging modalities available. This paper is the first to document the prevalence of drawing amongst surgeons, substantiates an informed professional opinion supporting this practice, and demonstrates widespread enthusiasm for further training in these skills.

Preparing for influenza outbreaks: the role of online educational resources

This article was migrated. The article was not marked as recommended. Introduction Influenza is a serious disease that can cause considerable morbidity and mortality. It results in regular seasonal outbreaks and occasionally in global pandemics. Healthcare professionals must learn about influenza (both pandemic and seasonal varieties) - however sometimes this disease can cause particular challenges to healthcare professional educators. E-learning modules may be an effective means of educating healthcare professionals on this subject.Methods BMJ Learning has published a series of modules on influenza - including seasonal and pandemic influenza. The goals of the modules were to help healthcare professionals learn about the assessment, diagnosis, differential diagnosis, and management of both seasonal and pandemic influenza. All healthcare professional users who completed the modules were encouraged to give free text feedback on the modules. We evaluated the modules by analysing this feedback from aqualitative perspective.Results Feedback to the modules was positive. Users appreciate the concise, case based and real-life nature of the modules. However, users expect the technology to be reliable and appreciate content in different formats - including text, audio and video. Some users had ongoing clinical learning needs - related to details on the diagnosis, differential diagnosis, and complications of influenza. Conclusions There have been hypotheses in the past that e-learning modules could play an important role in infectious disease outbreaks. This paper suggests that they do have a role. To maximise their effectiveness it is likely that modules need to be concise, case based and in a variety of different formats.

2483 The Empower Lab: An innovative model for research experience and training for undergraduate, graduate, and medical students

OBJECTIVES/SPECIFIC AIMS: The Empower Lab was established in 2015 with the goal of providing students with hands-on research experience in sexual and gender-based violence and health. METHODS/STUDY POPULATION: The Empower Lab consists of 10–12 undergraduate, graduate, and medical students at a time. Students undergo a rigorous application process, and agree to volunteer 8 hours per week for at least 1 year. Students are assigned to teams, and learn research skills such as literature searches, systematic reviews, research question generation, study design, IRB procedures, database creation and management, data collection and analysis, oral and poster presentation, manuscript preparation, team collaboration and communication, advocacy, and leadership. Students start as research assistants, and can be promoted to team leader, and associate director of research. Students mentor and teach each other, and are supervised by the principal investigator (PI). A survey skill self-assessment is administered to lab members on entry to the lab, every 4–6 months, and upon exit. RESULTS/ANTICIPATED RESULTS: In total, 20 students have participated in the lab to date, and 12 are currently enrolled. Eighty percent of the lab members are women. The students are 45% undergraduates, 15% graduate (nursing, social work, public health), 20% medical students, and 10% not currently enrolled in school (gap year). Twenty students completed entry surveys, 11 students have completed interim surveys, and 5 students have completed exit surveys. Examination of current surveys indicates that students are gaining skills throughout the lab experience. Free-text feedback provided further insight. Currently, the lab has 5 IRB-approved studies actively recruiting participants, 4 manuscripts being written, and 3 studies in the development phase. Students have presented at three local and 2 national meetings to date. Changes have been made to the lab structure over time in order to provide clear expectations and feedback, and strengthen student performance. DISCUSSION/SIGNIFICANCE OF IMPACT: The Empower Lab is an innovative public health lab that provides opportunities for real-world research experience for students. The teamwork, collaboration, and structure of the lab permit mentoring, support, and teaching from peers, as well as from the PI. The Lab increases the PI’s productivity. Students are encouraged to develop and implement their own research ideas, further encouraging independence and initiative. Although the number of surveys is limited to date, they indicate improvement in skills and confidence among lab members. The predominance of women in the lab suggests that this is a strong model for recruitment and retention of women in STEM.

Patient feedback on a new method of consulting with the GP; an analysis of responses by users of online triage software

BackgroundOnline triage software is a new way to triage patients online that allows patients to describe their problem via an online form. A GP then contacts the patient to arrange either a face-to-face or telephone consultation.AimThis study aimed to explore use of online consultation software and gain insight into patients’ experiences of using online consultations, identifying potential barriers and facilitators to use.MethodThis is a mixed methods retrospective study analysing data about patient users and their associated feedback. Data from a sample of 5591 patients were quantitatively analysed to describe characteristics of users. 576 out of the 5591 users left free-text feedback comments on their experience of use. These were thematically analysed.ResultsThe highest levels of use were observed in 25–35-year olds and lowest from those aged >65. Key themes identified included convenience, consultation quality, appropriateness, resource-use and functionality. Within each, a range of subthemes were present representing both positive and negative perceptions, suggesting that experiences of using online triage varied and were often context-dependentConclusionThere are various advantages to online triage software, but these are context-dependent. Therefore, such applications should be offered as an additional way to contact the GP surgery, rather than a replacement for more established methods, to ensure appropriate and equal access for patients.

Physician satisfaction with a critical care clinical information system using a multimethod evaluation of usability

IntroductionPhysician satisfaction with electronic medical records has often been poor. Usability has frequently been identified as a source for decreased satisfaction. While surveys can identify many issues, and are logistically easier to administer, they may miss issues identified using other methods This study sought to understand the level of physician satisfaction and usability issues associated with a critical care clinical information system (eCritical Alberta) implemented throughout the province of Alberta, Canada. MethodAll critical care attending physicians using the system were invited to participate in an online survey. Questions included components of the User Acceptance of Information Technology and Usability Questionnaire as well as free text feedback on system components. Physicians were also invited to participate in a think aloud test using simulated scenarios. The transcribed think aloud text and questionnaire were subjected to textual analysis. Results82% of all eligible physicians completed the on-line survey (n = 61). Eight physicians were invited and seven completed the think aloud test. Overall satisfaction with the system was moderate. Usability was identified as a significant factor contributing to satisfaction. The major usability factors identified were system response time and layout. The think aloud component identified additional factors beyond those identified in the on-line survey. ConclusionThis study found a modestly high level of physician satisfaction with a province-wide clinical critical care information system. Usability continues to be a significant factor in physician satisfaction. Using multiple methods of evaluation can capture the benefits of a large sample size and deeper understanding of the issues.

Students with an autonomous role in hospital care – patients perceptions

Background: There have been calls to enhance clinical education by strengthening supported active participation (SAP) of medical students in patient care. This study examines perceived quality of care when final-year medical students are integrated in hospital ward teams with an autonomous relationship toward their patients.Methods: We established three clinical education wards (CEWs) where final-year medical students were acting as “physician under supervision”. A questionnaire-based mixed-method study of discharged patients was completed in 2009–15 using the Picker Inpatient Questionnaire complemented by specific questions on the impact of SAP. Results were compared with matched pairs of the same clinical specialty from the same hospital (CG1) and from nationwide hospitals (CG2). Patients free-text feedback about their hospital stay was qualitatively evaluated.Results: Of 1136 patients surveyed, 528 (46.2%) returned the questionnaire. The CEWs were highly recommended, with good overall quality of care and patient-physician/student-interaction, all being significantly (p < 0.001) higher for the CEW group while experienced medical treatment success was similar. Patient-centeredness of students was appreciated by patients as a support to a deeper understanding of their condition and treatment.Conclusion: Our study indicates that SAP of final-year medical students is appreciated by patients with high overall quality of care and patient-centeredness.

Faculty feedback versus residents' self-assessment of operative performance: Different but complementary

BackgroundSurgical training requires development of both technical and cognitive skills. The study analyzed feedback by faculty and residents' self-assessments during a laparoscopic training course to identify structure of feedback in this context and compared the focus of trainees to faculty. MethodsThis study collected assessments by surgical residents and faculty during an intensive laparoscopic training course at a single institution. The residents' operative performance was assessed using validated assessment tools including free text feedback. Assessments were completed immediately following procedures. Feedback was analyzed using qualitative method. ResultsEighty (80) residents participated. Three themes were identified: Assessment, instruction and occasion. Faculty provided significantly more feedback than trainees. Moreover, the content of feedback was different. Residents focused on technical performance, while faculty commented on technical and cognitive skills, efficiency and level of independence. Errors were mainly addressed by faculty. ConclusionThis study demonstrated differences in cognitive focus of trainees and faculty. Text feedback is informative in understanding perceived challenges. Faculty provided explicit assessment and instruction for improvement. The effectiveness of self-assessment and feedback should be further studied.