Innovation in Student and Resident Feedback in Longitudinal Models Lisa Grill Dodson, MD Campus Dean, MCW-Central Wisconsin ldodson@mcw.edu Stuart Hannah, MD Program Director, Baraboo Family Medicine stuart.Hannah@famed.wisc.edu

Disclosures The speakers have no conflicts of interest to report.

Goals Increase efficiency of evaluation of medical students and residents in the clinical setting Improve the value of clinical evaluations to learners

Feedback vs Evaluation Formative Frequent, ongoing Often free form Suggestions for further work Intended to improve performance Evaluation Summative Comparison of actual performance to requirements or standards Usually standardized Document achievement or competence

Making Feedback Effective Timely (“on the fly”) Specific Actionable Include both positive and constructive negative Can be followed up Specific tools and techniques can help

Generational issues: Gestalt vs Micro feedback Baby Boomers (born 1946-1962ish): Live to work General feedback: “No news is good news” Gen X (born 1962-1980): Work to live Individual feedback Millenials (born 1981-1995) Want meaningful work, work-life balance Expect constant feedback/mentoring, usually positive

Resident “Point of Care” Feedback Direct observation In the room – role-modeling exams, double checking findings, confirming history, supervising procedures Video / streaming – HIPAA compliance needed, patient consent, may remove the “observer” effect Apps Mobile Medical Milestones – “M3” Global progress with local details Field notes – someone to correlate and “see big pic”

Old school: Daily goal cards (students) Goal for day: musculoskeletal exam Goal for Pt: Shoulder exam Patient: PJ Lessons learned (student): shoulder exam is more complicated than I thought Feedback (faculty): your shoulder exam was not complete, you did not understand several important diagnostic maneuvers Resources (student or faculty): Read AFP article on shoulder exam Follow up (student or faculty): Demonstrate shoulder exam tomorrow Patient(s): PJ (shoulder) LM (back) GG (ankle) Feedback (faculty): Review back exam- you missed several key elements. Review shoulder surface anatomy. You provided excellent patient ed on ankle sprain Resources (student or faculty): watch Youtube video on shoulder exam Follow up(student or faculty): demonstrate shoulder exam tomorrow

Timeless: TIPPS (students) “Teach in the Presence of the Patients” Saves time Well accepted by patients and students DO Involve patient as a teacher Provide praise and gentle correction DON’T Reprimand or humiliate student Engage in complex teaching points or concepts

Cutting edge: Daily (on the fly) Voice feedback procedure (students or residents) (instructions for iphone) Tap “voice memo” app (comes with your iphone) Click the red button and speak Give a couple of positives and a couple of points for improvement Tap red button to end Click “done” Name the recording (student name and date) Click “save” Tap the recording file Click on the upload square Tap on the “message” or “mail” icon, complete the “to” line and click “Send”

What are your tips for the group?