Health Sciences Education Symposium

First Author Information

Meagan Shinbashi, MD Candidate, Virginia Commonwealth University School of Medicine

Additional Author(s) Information

Richard Sofoluke, Geisinger Commonwealth School of Medicine

Jessica Randolph MD, Department of Ophthalmology, Virginia Commonwealth University Health System

Presentation Format

Poster

Type of Activity

Research

Original Presentation Date

2023

Date of Submission

March 2023

Abstract/Short Description

Purpose/Background/Objectives: Little research has been performed on the use of positive feedback as a teaching tool in ophthalmology postgraduate medical education settings. Additionally, there is a paucity of research assessing the effectiveness of feedback from trainees’ perspectives. To address these gaps, we explored the effects of positive feedback on resident professional identity formation, performance, and wellness through a pilot program within the ophthalmology residency program’s wellness curriculum at Virginia Commonwealth University.

Methods: This study employed quantitative data collection through surveys before and after a positive feedback exercise activity of ophthalmology residents at the Virginia Commonwealth University Health System. Participants were recruited through email invitation and given a voluntary choice to participate. Data collection began in March 2022 and was completed in April 2022. In total, 14 residents were given a pre-activity survey assessing their self-esteem and performance as an ophthalmology resident. Residents responded to 4 statements, which consisted of: 1) I feel like I am doing a good job as a resident, 2) I feel confident at work, 3) I feel like my feedback at work is (positive or negative), and 4) I have imposter syndrome. Responses were measured using the Likert Scale, an ordinal scale used by respondents to rate the degree to which they agree or disagree with a statement. Following the pre-activity survey, positive feedback regarding all 14 residents was anonymously collected from staff and faculty who interacted with them on a daily basis. These comments were subsequently read aloud to each of the residents during an ophthalmology resident wellness day event. Residents were then asked to complete a post-activity survey with the same prompts in the pre-activity survey, as well as two additional statements: 1) I feel like this exercise helped my self-esteem and 2) I found this exercise helpful. Results were again measured using the Likert Scale. Finally, residents were given the chance to provide comments regarding the exercise in the post-activity survey.

Results: 11 residents (78.6%) completed the pre-activity survey and 9 residents (64.3%) completed the post-activity survey. 66.7% of participants reported improvements in their self-esteem following the positive feedback exercise, and 77.7% of residents reported that the exercise was helpful. All additional comments collected expressed approval of the exercise and a desire to permanently incorporate it into the wellness curriculum.

Conclusions/Reflective Critique: Modifiable barriers to resident wellness include unfriendly work environments and lack of wellness initiatives. While we acknowledge that changing the culture of medicine is difficult, thoughtful implementation of positive feedback offers an avenue for residency programs to combat these barriers and create a nurturing environment that promotes wellness. In our study, residents reported increased confidence in their abilities and work following the positive feedback exercise. Notably, residents also reported experiencing less imposter syndrome, or the feeling of being “a fraud” that originates from self-doubt in one’s abilities. These results give further evidence that positive feedback can both combat physician burnout and increase trainee competence in residency programs.The main limitation of this study is the small sample size, but as this is a pilot program there is the opportunity for growth and expansion. It is our hope to implement this in future studies to assess the change in outcomes during the development of residents’ skills as they progress through the residency program. In summary, although both positive and negative feedback can be used to improve trainee self-awareness and technical skills, the added value of positive feedback on trainees’ psyches should not be overlooked. Proper use of positive feedback can significantly improve trainees’ professional identity, confidence, and enthusiasm, and should be utilized more in surgical education.

References

1. Paterson C, Paterson N, Jackson W, Work F. What are students’ needs and preferences for academic feedback in higher education? A systematic review. Nurse Education Today. 2020;85:104236. doi:10.1016/j.nedt.2019.104236

2. Jug R, Jiang X “Sara”, Bean SM. Giving and Receiving Effective Feedback: A Review Article and How-To Guide. Archives of Pathology & Laboratory Medicine. 2018;143(2):244-250. doi:10.5858/arpa.2018-0058-RA

3. Ende J. Feedback in Clinical Medical Education. JAMA. 1983;250(6):777-781. doi:10.1001/jama.1983.03340060055026

4. Saedon H. An analysis of ophthalmology trainees’ perceptions of feedback for cataract surgery training. Clin Ophthalmol. 2014;8:43-47. doi:10.2147/OPTH.S54979

5. Race DA, Williams MG. Digital Audio Feedback Technology: Nursing Students’ Perspectives. CIN: Computers, Informatics, Nursing. 2018;36(2):63-67. doi:10.1097/CIN.0000000000000418

6. El Boghdady M, Alijani A. Feedback in surgical education. The Surgeon. 2017;15(2):98-103. doi:10.1016/j.surge.2016.06.006

7. Spiotta AM, Fargen KM, Patel S, Larrew T, Turner RD. Impact of a Residency-Integrated Wellness Program on Resident Mental Health, Sleepiness, and Quality of Life. Neurosurgery. 2019;84(2):341-346. doi:10.1093/neuros/nyy112

8. Edmondson EK, Kumar AA, Smith SM. Creating a Culture of Wellness in Residency. Acad Med. 2018;93(7):966-968. doi:10.1097/ACM.0000000000002250

9. Lorch AC, Kloek CE. An evidence-based approach to surgical teaching in ophthalmology. Surv Ophthalmol. 2017 May- Jun;62(3):371-377. doi: 10.1016/j.survophthal.2017.01.003. Epub 2017 Jan 17. PMID: 28104385.

Rights

© The Author(s)

Is Part Of

VCU Medical Education Symposium

Share

COinS