APGO

Purpose: To evaluate the effect of a learner-initiated framework for perioperative feedback on the frequency and satisfaction of resident feedback.

Background:  Procedural feedback is an important aspect of resident education and surgical performance improvement.  Satisfaction with feedback has been low in our program (64% reported somewhat, very or extremely satisfied) compared to the ACGME national average (72%).

Methods: This is a prospective cohort study of OBGYN residents at Los Angeles County+USC Medical Center.  A learner-initiated framework was implemented for 3 months of gynecologic cases. After a pre-survey was performed the framework was introduced via didactic.  Residents completed immediate postoperative surveys following each case.  Residents and faculty completed a post-intervention survey.  Primary outcome was proportion of cases in which feedback was given.  To detect a 25% difference in feedback frequency, a total of 99 cases were required with 80% power.

  

Results: Before intervention, residents reported feedback in 25 of 42 cases (59.5%), compared to 82 of 122 cases (67.2%) during the study period (NS). Resident satisfaction (reported sometimes, very, or extremely satisfied) with feedback increased from 67.9% to 90.3% (p=0.003).  Residents also reported both more frequent review of case goals (p<0.01) and receipt of feedback (p=0.007).  

Discussion: Learner-initiated framework objectively raised frequency of feedback received from faculty, albeit non-significantly.  Subjectively, residents indicated they received more frequent feedback and were more satisfied with that feedback.  This trial demonstrated that a formal framework for perioperative feedback significantly improved resident satisfaction with feedback and should be considered for routine use at USC.