Improving Formative Feedback in the Operating Room Setting: Developing and Implementing an Initiative to Improve Feedback Quality and Culture. 2022

Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
O. Onuoha was associate professor, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania at the time of writing. She is currently associate professor of anesthesiology, McGovern Medical School at UTHealth, Houston, Texas.

Formative feedback, given in an ongoing fashion during the learning process, is fundamental to clinical education. However, dissatisfaction with formative feedback among residents is common. Difficulties with formative feedback are intensified in the operating room (OR) setting due to fast pace, space limitations, and frequent rotation of residents and attendings. In the anesthesiology and critical care department at the University of Pennsylvania Perelman School of Medicine, the authors launched the Feedback Moment initiative from January 2018 to May 2018 in which 24 first-year residents and attendings were given a short series of prompts designed to facilitate regular, high-quality formative feedback. The authors conducted semistructured interviews with residents before and after the initiative to evaluate its impact. In baseline interviews, 18 participating residents stressed the importance of formative feedback but described feeling unsure of their performance due to lack of ongoing constructive input from attendings. They felt hesitant to approach attendings for feedback due to a desire not to interrupt OR workflow or appear incompetent. In follow-up interviews, residents described the initiative as helping to normalize constructive formative feedback but difficult to execute regularly due to OR workflow issues and frequent rotation of attendings with varying approaches. Challenges faced by participants in this initiative highlight several considerations for effective OR-based formative feedback. Alternative timings for initiating feedback must be considered in light of the hectic nature of the OR workflow. Residents should be equipped with the skills necessary to adapt to varying practice patterns and frequent rotation between attendings, while attendings should be trained to provide a clear rationale for constructive feedback that allows residents to quickly adapt to practice variation. Finally, establishing clear goals among resident-attending pairs is critical to ensuring that formative feedback given in necessarily brief sessions is focused and productive.

UI MeSH Term Description Entries
D007396 Internship and Residency Programs of EDUCATION, MEDICAL, GRADUATE training to meet the requirements established by accrediting authorities. House Staff,Internship, Dental,Residency, Dental,Residency, Medical,Dental Internship,Dental Internships,Dental Residencies,Dental Residency,Internship,Internship, Medical,Internships, Dental,Medical Residencies,Medical Residency,Residencies, Dental,Residencies, Medical,Residency,Residency and Internship,Internships, Medical,Medical Internship,Medical Internships,Residencies,Staff, House
D009873 Operating Rooms Facilities equipped for performing surgery. Operating Room,Room, Operating,Rooms, Operating
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D000068156 Formative Feedback Information communicated to the learner that is intended to modify the learner’s thinking or behavior for the purpose of improving learning. Constructive Feedback,Feedback (Learning),Feedback, Constructive,Feedback, Formative
D015143 Philadelphia City located in Pennsylvania.

Related Publications

Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
October 2014, Anesthesia and analgesia,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
August 2022, Paediatric anaesthesia,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
July 1983, American journal of hospital pharmacy,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
April 2017, AANA journal,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
July 2022, The American surgeon,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
January 2010, The American journal of nursing,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
May 2019, Applied clinical informatics,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
January 1992, Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
February 2015, JAMA surgery,
Onyi Onuoha, and Sarah J Heins, and Justin T Clapp, and Madhavi Muralidharan, and Dimitry Y Baranov, and Lee A Fleisher, and Emily K B Gordon
June 2013, Journal of preventive medicine and hygiene,
Copied contents to your clipboard!