Effect of an Educational Intervention on Faculty and Resident Satisfaction with Real-time Feedback in the Emergency Department

Authors

  • Lalena M. Yarris MD, MCR,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • Rongwei Fu PhD,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • Joseph LaMantia MD,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • Judith A. Linden MD,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • H. Gene Hern MD, MS,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • Cedric Lefebvre MD,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • David M. Nestler MD, MS,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • Janis Tupesis MD,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • Nicholas Kman MD,

    1. From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (LMY, RF), and the Department of Public Health and Preventive Medicine (RF), Oregon Health & Science University, Portland, OR; the Department of Emergency Medicine, North Shore University Hospital (JL), Manhasset, NY; the Department of Emergency Medicine, Boston Medical Center and Boston University School of Medicine, (JAL) Boston, MA; Department of Emergency Medicine, Alameda County–Highland General Hospital (HGH), Oakland, CA; the Department of Emergency Medicine, Wake Forest University Health Sciences (CL), Winston-Salem, NC; the Department of Emergency Medicine, Mayo Clinic (DMN), Rochester, MN; the Department of Emergency Medicine, The Ohio State University Medical Center (NK), Columbus, OH; and the Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health (JT), Madison, WI.
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  • on behalf of the Emergency Medicine Education Research Group (EMERGe)


  • Emergency Medicine Education Research Group (EMERGe) members are listed in Appendix A.

  • Presented at the Society for Academic Emergency Medicine (SAEM) Annual Meeting, New Orleans, LA, May 2009, and the following SAEM Regional Research Forums: New England, March 2009; Mid-Atlantic, March 2009; Southeastern, March 2009; and Western, January 2009.

  • This publication was made possible with support from the Oregon Clinical and Translational Research Institute (OCTRI), grant UL1 RR024140 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research.

  • The authors have no relevant financial information or potential conflicts of interest to disclose.

  • Supervising Editor: Jacob W. Ufberg, MD.

Address for correspondence and reprints: Lalena M. Yarris, MD, MCR; e-mail: yarrisl@ohsu.edu.

Abstract

Academic Emergency Medicine 2011; 18:504–512 © 2011 by the Society for Academic Emergency Medicine

Abstract

Objectives:  Effective real-time feedback is critical to medical education. This study tested the hypothesis that an educational intervention related to feedback would improve emergency medicine (EM) faculty and resident physician satisfaction with feedback.

Methods:  This was a cluster-randomized, controlled study of 15 EM residency programs in 2007–2008. An educational intervention was created that combined a feedback curriculum with a card system designed to promote timely, effective feedback. Sites were randomized either to receive the intervention or to continue their current feedback method. All participants completed a Web-based survey before and after the intervention period. The primary outcome was overall feedback satisfaction on a 10-point scale. Additional items addressed specific aspects of feedback. Responses were compared using a generalized estimating equations model, adjusting for confounders and baseline differences between groups. The study was designed to achieve at least 80% power to detect a one-point difference in overall satisfaction (α = 0.05).

Results:  Response rates for pre- and postintervention surveys were 65.9 and 47.3% (faculty) and 64.7 and 56.9% (residents). Residents in the intervention group reported a mean overall increase in feedback satisfaction scores compared to those in the control group (mean increase 0.96 points, standard error [SE] ± 0.44, p = 0.03) and significantly higher satisfaction with the quality, amount, and timeliness of feedback. There were no significant differences in mean scores for overall and specific aspects of satisfaction between the faculty physician intervention and control groups.

Conclusions:  An intervention designed to improve real-time feedback in the ED resulted in higher resident satisfaction with feedback received, but did not affect faculty satisfaction with the feedback given.

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