Feedback Versus Feeding A Randomized Controlled Trial ML Boehler, DA Rogers, CJ Schwind R Mayforth, J Quin, R Williams, G Dunnington Southern Illinois University Surgery Education & Performance Group

Introduction  Feedback is important in improving performance  Medical students are chronically dissatisfied with feedback

Prior Interventions “Faculty Focused”  “One Minute Preceptor” (Neher et al, 1992)  “Residents as Teachers” (Dunnington, DaRosa, 1998)

Prior Interventions “Student Focused”  Microskills for Students (Lipsky, Taylor, Schnuth, 1999)  Encounter Cards (Greenberg, 2004)  Prescriptions (Prystowsky, DaRosa, 2003)  Learning Contract (Bing-you, Bertsch, Thompson, 1998)

Question? Do medical students and faculty have different expectations of feedback?

Additional Concerns Compliments may produce the more satisfied (but less capable) medical student.

Compliment - Definition Something said in admiration, praise, or flattery. (Websters)

Compliment Examples Great Job Your Making Progress Your doing great Looks Good Outstanding Fantastic Progress

Feedback - Definition The return of information about the result of a process.

Feedback - Examples “You didn’t start with your hands crossed – You are using both hands, everything is done with the left hand, now rotate the loop towards you, concentrate on using your left hand.”

Study Questions?  Will medical students that receive compliments be more satisfied than students that receive feedback?  Will medical students receiving feedback demonstrate improved performances as compared to those receiving just compliments?

Methods  Subjects were 2 nd & 3 rd year medical students  Knot Tying Skills Session  Pretest Videotape

Intervention  Random selection into two groups  Compliments  Feedback  Post Intervention tape

Methods Very Poor Un- acceptable AcceptableGoodVery Good Truly Exceptional Global Satisfaction Survey

Video Analysis  Randomized Videos  Three Faculty Raters  Instrument Range 0-32

Statistical Methods  Intra-class Correlation  Paired Sample t-test  Within Group Differences  Independent Sample t-test  Between Group Differences  Mann-Whitney U  Satisfaction Ratings

Results  33 Subjects  Inter-rater Reliability  Pre-Instruction =.80  Post Instruction =.82  Post Intervention =.83

Satisfaction Results

Performance Results

Conclusion  Feedback improved performance  Compliments resulted in the greater satisfaction  Combine global compliments with specific feedback  Use caution with satisfaction surveys