Effectiveness of a focused educational intervention on resident evaluations from faculty a randomized controlled trial.

Abstract

OBJECTIVE: To improve the quality and specificity of written evaluations by faculty attendings of internal medicine residents during inpatient rotations. DESIGN: Prospective randomized controlled trial. SETTING: Four hospitals: tertiary care university hospital, Veterans' Administration hospital, and two community hospitals. PARTICIPANTS: Eighty-eight faculty and 157 residents from categorical and primary-care internal medicine residency training programs rotating on inpatient general medicine teams. INTERVENTION: Focused 20-minute educational session on evaluation and feedback, accompanied by 3 by 5 reminder card and diary, given to faculty at the start of their attending month. PRIMARY OUTCOMES: 1) number of written comments from faculty specific to unique, preselected dimensions of competence; 2) number of written comments from faculty describing a specific resident behavior or providing a recommendation; and 3) resident Likert-scale ratings of the quantity and effect of feedback received from faculty. Faculty in the intervention group provided more written comments specific to defined dimensions of competence, a median of three comments per evaluation form versus two in the control group, but when adjusted for clustering by faculty, the difference was not statistically significant (P =.09). Regarding feedback, residents in the intervention group rated the quantity significantly higher (P =.04) and were significantly more likely to make changes in clinical management of patients than residents in the control group (P =.04). CONCLUSIONS: A brief, focused educational intervention delivered to faculty prior to the start of a ward rotation appears to have a modest effect on faculty behavior for written evaluations and promoted higher quality feedback given to house staff.