1. Quality of Interprofessional Feedback for First-Year Medical Students: A Content Analysis
Anelah McGinness1; Maria Wamsley, MD1; Josette Rivera, MD1
1University of California, San Francisco
Interprofessional (IP) feedback can foster development of the collaboration skills1 needed to be successful in today’s healthcare environments.
Although IP feedback is gaining traction in GME, most medical students graduate without ever receiving feedback from a non- physician - a missed opportunity.
Common obstacles to IP feedback:2, 3
Lack of non-physician provider training in giving feedback
Minimal student interaction with IP team members due to differences in work schedules, team configurations, other responsibilities
Burden of filling out feedback forms
Keeping the survey simple (2 open-ended items) combined with a longitudinal clinical placement may overcome some of the barriers inherent in IP feedback
Introduction
Results
Table 2. Example Interprofessional Feedback Comments
Global personality judgment
“respectful & inquisitive…she’s extremely open to learning new things”
Behavior oriented
“asks appropriate questions and listens intently”
Specific instance of behavior
“sent a reminder with the names of the patients that she wanted to reach and checked in on…any roadblocks”
Reinforcing
“asked insightful questions”
Constructive – general
“Be more vocal”
Constructive – specific strategy for improvement
“let the other professionals…know when something can be expected to be completed (immediately, the next day, in a few days/weeks, etc.)”
Interprofessional Education Collaborative Competencies
Values/ethics
“Well prepared for his patients, very professional”
Roles and responsibilities
“demonstrated understanding about roles & responsibilities of each discipline involved in patient care plan.”
Communication
“Voices her ideas clearly and succinctly. Listens to understand, not to respond”
”Very open to feedback”
Teams/teamwork
“investigates the perspectives of other stakeholders and takes this into account”
“strong leadership skills.”
Table 1. Descriptive Statistics
Profession of Interprofessional Feedback Provider
Nurse (RN, LVN)
19% (41)
Advanced practice nurse**
14% (32)
Pharmacist
11% (24)
Social worker
5% (12)
Physical Therapist
3% (7)
Medical Assistant
2% (4)
Physician
1% (2)
Dentist, pharmacist technician,
<1%
Other*
45% (100)
Interaction of Feedback Provider with Medical Student
Type of interaction
Systems Improvement
75% (168)
Patient Care
Both
17% (38)
Neither
Number of interactions
1-4 days
54% (118)
5-8 days
27% (59)
9-12 days
2%(4)
13-15 days
>15 days
4%(9)
*Other: psychologist, epidemiologist, analyst, administrative manager, counselor, and coordinators of clinical research, patient care, or coordinators of specific projects
**Nurse practitioner, clinical nurse specialist, certified nurse midwife, pediatric nurse practitioner
152 first year medical students enrolled in a required 15-month longitudinal, weekly half-day clinical placement. Supervised by a faculty coach, students learned IP collaboration and direct patient care skills, and completed a systems improvement project.
Students solicited feedback at 2 time points (Month 2 and Month 7) by giving providers a link to a 2 item, open-ended online form for feedback.
Feedback was non-anonymous and formative.
The survey also asked providers to identify their profession, and the amount/type of contact with the student.
We used directed content analysis to characterize feedback according to a published scheme4 as follows: specificity (global personality vs. behavior vs. specific behavior), valence (reinforcing vs. constructive/corrective comments). Constructive feedback was further analyzed for specificity (general vs. specific strategy for improvement).
Comments were also categorized according to IPEC competency domains1 (communication, values/ethics, teams/teamwork, and roles/responsibilities).
Percentages calculated with total number of comments as the denominator.
Methods and Materials
A simple two-item, open-ended survey can provide interprofessional (IP) feedback on collaboration skills that is specific and behavior-oriented – with minimal training of feedback providers.
Lack of specific, substantive constructive feedback hindered feedback quality.
Many feedback providers (54%) had limited contact with the student (1-4 days).
Most providers (75%) interacted with students through their systems improvement project, suggesting a possible role for projects in fostering IP interactions.
Discussion
General Strategy
Specific Strategy
No Strategy
To increase interprofessional (IP) feedback quality we will:
Push back the feedback timeline to allow more time for IP interactions
Add structured, workplace-based IP activities to foster more interactions between students and their IP colleagues
Send IP feedback directly to students and coaches to encourage student reflection5 and formal debriefing with faculty coach.
Lessons Learned
152 students enrolled in 15 month longitudinal clinical placement
Month 0
12% (n=18) received feedback 0 of 2 times
29% (n=44) received feedback 1 of 2 times
59% (n=90) received feedback 2 of 2 times
Month 15 (end)
Request IP feedback
(2 of 2)
74% (n=112) completion
Month 7
(1 of 2)
71%(n=108) completion
Month 2
Figure 2. Characteristics of Interprofessional Feedback. Feedback was largely behavior based and specific, but lacked constructive strategies. Providers provided feedback that aligned with identified competencies of effective interprofessional collaboration.
Figure 1. Diagram of feedback collection process and completion rates.
Authors
References
Anelah McGinness; University of California, San Francisco;
Maria Wamsley; University of California, San Francisco;
Josette Rivera; University of California, San
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