Through the Looking Glass: Comparing Hospitalists' and Internal Medicine Residents' Perceptions of Feedback.

Feedback is critical for resident growth and is most effective when the relationship between residents and attendings is collaborative, with shared expectations for the purpose, timing, and manner of communication for feedback. Within internal medicine, there is limited work exploring the resident and hospitalist perspectives on whether key elements are included in feedback sessions. We surveyed internal medicine residents and supervising hospitalists at a large urban training program about their perspectives on four components of effective feedback: specificity,timeliness, respectful communication, and actionability. We received surveys from 130/184 internal medicine residents and 74/129 hospitalists (71% and 57% response rate, respectively). Residents and hospitalists differed in their perspectives about specificity and timeliness: 54% (70/129) of residents reported they did not receive specific feedback while 90% (65/72) of hospitalists reported they delivered specific feedback (p<0.01), and 33% (43/129) of residents compared with 82% (59/72) of hospitalists perceived feedback as timely (p<0.01). Internal medicine residents and hospitalists reported concordant rates of feedback sessions consisting of a two-way conversation (84%, 109/129; 89%, 64/72, respectively, p=0.82) and that communication was delivered in a respectful manner (95%, 122/129; 97%, 70/72, respectively, p=0.57). We observed discordance between internal medicine residents and supervising hospitalist perspectives on the inclusion of two critical components of feedback: specificity and timing. The hospitalist cohort reported delivering more components of effective feedback than the resident cohort reported receiving. The etiology of this discordance is likely multifactorial and requires further investigation.

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Human subjects: Consent was obtained or waived by all participants in this study. University of Washington Human Subjects Division issued approval with IRB ID STUDY00017694. University of Washington Human Subjects Division (HSD) issued the following approval letter. Dear Jeffrey W. Redinger: On 4/4/2023, the University of Washington Human Subjects Division (HSD) reviewed the following application: Type of Review: Initial Study Title of Study: Direct observation of feedback delivered by Internal Medicine attending physicians to Internal Medicine residents: a coaching program. Investigator: Jeffrey W. Redinger IRB ID: STUDY00017694 Funding: None Exempt Status HSD determined that your proposed activity is human subjects research that qualifies for exempt status (Categories 1 & 2). This determination may or may not be based on the Limited IRB Review process. This determination is valid for the duration of your research. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.