Quality of Interprofessional Feedback Given to Medical Students During a Psychiatry Rotation

Feedback is an important aspect of clinical medical education. To be effective and actionable, feedback should be specific,(1,2) although several studies have shown that in practice this is often not accomplished.(3-5) In addition to physician feedback, medical learners are likely interested in(6) and can benefit from(7) interprofessional feedback. While two recent studies have analyzed interprofessional feedback given to medical students, they did not do so in the context of 3rd and 4th year clinical rotations.(8,9) The aim of the present study was to evaluate the quality of written feedback given to medical students by members of other professions during an in-patient psychiatry rotation and also to determine whether quality varied by profession. Free response written feedback was collected as part of a truncated version of the Individual Teamwork Observation and Feedback Tool (iTOFT)(10) completed by nurses, social workers, therapists, advanced practice providers, pharmacists, and other members of the interdisciplinary team. A coding scheme described by Shaughness et al.(4) was emulated to assess feedback contents and quality. From 330 completed free responses out of 346 consented forms, directed qualitative content analysis utilizing two independent coders was performed to assess whether feedback contained elements that were specific (18.8%), non-specific (97.9%), encouraging (100%), and corrective (0.9%). Based on the presence of specific and non-specific elements, feedback was recategorized as being effective (2.1%), mediocre (16.7%), or ineffective (81.2%). Analysis with two-tailed Fisher’s exact test showed that feedback contents and quality did not significantly differ across professions. Similar to previous findings on feedback from physicians by Shaughness et al.,(4) the majority of comments were non-specific and encouraging while often containing superlatives and global praise, though this occurred to an even greater extent in the present study. While such feedback may be perceived positively, it is less likely to produce behavior change than specific and corrective feedback.(11) Another notable result was the near-complete absence of corrective feedback. Some possible explanations are that members of other professions are not accustomed to or do not feel comfortable with giving this type of feedback directly to medical students. There likely remains untapped potential to acquire effective input from other professionals. Strategies to produce higher quality written feedback could include training of evaluators(5) or using forms that prompt for more specific comments.(9,12)

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