Wednesday, July 1, 2015

Multisource Feedback to Pediatric Residents: The Efficacy of an ACGME Competency-Based Assessment Tool

William Brinkman, MD, MEd
Cincinnati Children's Hospital Medical Center

Objective: To determine whether augmenting standard feedback on resident performance with a multi-source feedback intervention improved pediatric resident communication skills and professionalism.

Design: Randomized controlled trial.

Setting: Children’s Hospital Medical Center, Cincinnati, Ohio, from June 2004 to June 2005.

Participants: Thirty-six first-year pediatric residents.

Interventions: Residents assigned to multi-source feedback (n=18) completed a self-assessment, received a feedback report regarding baseline parent and nurse evaluations, and participated in a tailored coaching session in addition to receiving standard feedback. Residents in the control group (n=18) received standard feedback only. The control group and their residency directors were blinded to parent and nurse evaluations until the end of the study.

Main Outcome Measures: Ratings of specific communication skills and professionalism behaviors by parents and nurses of pediatric patients. Both groups were evaluated at baseline and five months later. Scores were calculated on each item as percentage in the highest response category.

Results: Both groups had comparable baseline characteristics and ratings. Parent ratings increased for both groups. While ratings increased more for the multi-source feedback group, differences between groups were not statistically significant. In contrast, nurse ratings increased for the multi-source feedback group and decreased for the control group. The differences in change between groups was statistically significant for communicating effectively with patient and family (35%, 95% confidence intervals 11 to 58), timeliness of completing tasks (30%, 7.9 to 53), and demonstrating responsibility and accountability (26%, 2.9 to 49).

Conclusions: A multi-source feedback intervention positively impacted communication skills and professional behavior amount pediatric residents.