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Physician characteristics associated with proficiency in feedback skills

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Abstract

BACKGROUND: Providing and eliciting high-quality feedback is valuable in medical education. Medical learners’ attainment of clinical competence and professional growth can be facilitated by reliable feedback. This study’s primary objective was to identify characteristics that are associated with physician teachers’ proficiency with feedback.

METHODS: A cohort of 363 physicians, who were either past participants of the Johns Hopkins Faculty Development Program or members of a comparison group, were surveyed by mail in July 2002. Survey questions focused on personal characteristics, professional characteristics, teaching activities, self-assessed teaching proficiencies and behaviors, and scholarly activity. The feedback scale, a composite feedback variable, was developed using factor analysis. Logistic regression models were then used to determine which faculty characteristics were independently associated with scoring highly on a dichotomized version of the feedback scale.

RESULTS: Two hundred and ninety-nine physicians responded (82%) of whom 262 (88%) had taught medical learners in the prior 12 months. Factor analysis revealed that the 7 questions from the survey addressing feedback clustered together to form the “feedback scale” (Cronbach’s α: 0.76). Six items, representing discrete faculty responses to survey questions, were independently associated with high feedback scores: (i) frequently attempting to detect and discuss the emotional responses of learners (odds ratio [OR]=4.6, 95% confidence interval [CI] 2.2 to 9.6), (ii) proficiency in handling conflict (OR=3.7, 95% CI 1.5 to 9.3), (iii) frequently asking learners what they desire from the teaching interaction (OR=3.5, 95% CI 1.7 to 7.2), (iv) having written down or reviewed professional goals in the prior year (OR=3.2, 95% CI 1.6 to 6.4), (v) frequently working with learners to establish mutually agreed upon goals, objectives, and ground rules (OR=2.2, 95% CI 1.1 to 4.7), and (vi) frequently letting learners figure things out themselves, even if they struggle (OR=2.1, 95% CI 1.1 to 3.9).

CONCLUSIONS: Beyond providing training in specific feedback skills, programs that want to improve feedback performance among their faculty may wish to promote the teaching behaviors and proficiencies that are associated with high feedback scores identified in this study.

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Authors and Affiliations

  1. Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Elizabeth P. Menachery MD, Amy M. Knight MD, Ken Kolodner ScD & Scott M. Wright MD

Authors
  1. Elizabeth P. Menachery MD
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  2. Amy M. Knight MD
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  3. Ken Kolodner ScD
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  4. Scott M. Wright MD
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Corresponding author

Correspondence to Elizabeth P. Menachery MD.

Additional information

None of the authors have any conflicts of interest to declare.

Dr. Wright is an Arnold P. Gold Foundation Associate Professor of Medicine. The authors are indebted to Dr. L. Randol Barker, Dr. David Kern, Ms. Cheri Smith, and Ms. Darilyn Rohlfing for their assistance.

Financial Support: The Johns Hopkins Faculty Development Program in Teaching Skills is supported by the Health Resources and Services Administration, Grant #5 D55HP00049-05-00.

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Menachery, E.P., Knight, A.M., Kolodner, K. et al. Physician characteristics associated with proficiency in feedback skills. J GEN INTERN MED 21, 440–446 (2006). https://doi.org/10.1111/j.1525-1497.2006.00424.x

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