Residents giving feedback to their supervising physicians using the EFFECT questionnaire

Residents giving feedback to their supervising physicians using the EFFECT questionnaire

Residents giving feedback to their supervising physicians using the EFFECT questionnaire

Background: It is of high importance that post-graduate medical education is supported by competent supervision in inspiring learning environments to meet the needs of cost-effective high-quality patient care. Training in clinical practice, places greater demands on the supervising physicians.

In Region Jönköping County, the program directors in residency programs since 2015 have implemented the EFFECT model, invented in the Netherlands, to strengthen supervising physicians and stimulate learning environments. Their studies have shown that the EFFECT model improve feedback and learning environment (Fluit, 2013). The implementation in Sweden is done in close collaboration with the inventor of the model in the Netherlands.
The first step in the model is a web-based questionnaire where supervisors make a self-evaluation and residents evaluate all supervising physicians at their department/health centre. The result of the questionnaires from each supervisor are used as background information for a feedback dialogue between a supervising physician and two residents, an upward feedback supported by a neutral moderator. This is part of my first study in my doctoral work following the implementation of EFFECT in Swedish hospitals and primary care.

Methods: Data consists of questionnaires from five different hospital departments and nine primary care units, representing 78 self-evaluation and 278 resident-evaluations. The questionnaire have 58 questions and are divided in seven domains: Role modelling (R), Assigning task relevant for learning (TA), Planning teaching (P), Feedback (F), Teaching methodology (TM), Personal support (PS) and Assessment (A). The questions were answered with a six-graded scale and written comments. If one could not answer the question, one chose: can´t be answered.

Result: The results per domain show that supervising physicians rates themselves generally lower, than the residents, and with some differences between departments and primary care. The residents are most satisfied with supervision in domain Personal support. In primary care, the supervising physicians rate themselves lower, in domain Assessment, than those in hospital departments. Residents seldom evaluate their supervisors with low ratings; they chose either good feedback or doesn’t answer the question.

Summary: Most residents evaluate their supervisors high in all domains, which is good, but especially in domain Feedback, many residents have not answered. It may suggest that a group of residents do not feel that they receive sufficient feedback in their daily work, while the supervisors report they do. Are the residents afraid of giving negative feedback? Alternatively, they have not received any feedback? Another question to think about is, what are considered to be feedback and how do the supervising physicians perform it?
The preliminary results from the questionnaires gives a lot of information but also raises many questions. A main question for the improvement of healthcare practise is how to create an environment where residents can give constructive feedback upwards to their supervising physicians.

Reference: Fluit, C. R. M. G. (2013). Evaluation and Feedback For Effective Clinical Teaching. Radboud University Nijmegen.


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