Positive Change in Feedback Perceptions and Behavior: A 10-Year Follow-up Study
Positive Change in Feedback Perceptions and Behavior: A 10-Year Follow-up Study
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DOI：
10.1542/peds.2017-2950
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发表时间：
2018-01-01
期刊：
影响因子：
8
通讯作者：
Rezet, Beth
中科院分区：
文献类型：
--
作者：
Balmer, Dorene F.;Tenney-Soeiro, Rebecca;Rezet, Beth
背景：提供反馈和从反馈中学习是医学教育的重要组成部分，通常被描述为抗拒变化。但是考虑到十年来反馈发生的临床背景的变化，作者询问反馈和反馈行为的感知是否以及如何改变以响应上下文启示。方法：2017年，作者进行了一次随访，在同一儿童医院的2个普通儿科楼层进行人种学研究，在同一儿童医院的1个普通儿科楼层进行另一项人种学研究，2007.数据来源包括（1）2007年和2017年分别观察21小时和34小时，（2）2007年和2017年分别对普通儿科主治医生和住院医师进行35次和25次访谈，以及（3）对2007年至2017年的120份计划文件的审查。数据围绕3项反馈建议进行编码和组织，这些建议来自2007年的数据，并作为评估2017年变化的标准。与2007年相比，2017年的参与者更清楚地区分了反馈和评价;居民对即时反馈的意识更强，他们已经从评价和评分转向反馈和学习。在实现的建议，这是来自于数据的进展，指出机构和国家的影响，即儿科milestones.CONCLUSIONS：在后续行动的基础上，人种学数据，儿科教育的临床背景下的变化可能会提供积极的变化反馈和反馈行为的看法，并指向机构内外的影响。
BACKGROUND: Providing and learning from feedback are essential components of medical education, and typically described as resistant to change. But given a decade of change in the clinical context in which feedback occurs, the authors asked if, and how, perceptions of feedback and feedback behaviors might have changed in response to contextual affordances.METHODS: In 2017, the authors conducted a follow-up, ethnographic study on 2 general pediatric floors at the same children's hospital where another ethnographic study on a general pediatric floor was conducted in 2007. Data sources included (1) 21 and 34 hours of observation in 2007 and 2017, respectively, (2) 35 and 25 interviews with general pediatric attending physicians and residents in 2007 and 2017, respectively, and (3) a review of 120 program documents spanning 2007 to 2017. Data were coded and organized around 3 recommendations for feedback that were derived from 2007 data and served as standards for assessing change in 2017.RESULTS: Data revealed progress in achieving each recommendation. Compared with 2007, participants in 2017 more clearly distinguished between feedback and evaluation; residents were more aware of in-the-moment feedback, and they had shifted their orientation from evaluation and grades to feedback and learning. Explanations for progress in achieving recommendations, which were derived from the data, pointed to institutional and national influences, namely, the pediatric milestones.CONCLUSIONS: On the basis of follow-up, ethnographic data, changes in the clinical context of pediatric education may afford positive change in perceptions of feedback and feedback behavior and point to influences within and beyond the institution.