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Applying a Competency-Based Medical Education Framework to Development of Residents’ Feedback Skills

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Abstract

Objective

Feedback is a critically important tool in medical education. This pilot program applies and evaluates a competency-based approach to develop residents’ skills in providing feedback to medical students.

Methods

In 2018–2019, a competency-based resident feedback skills program incorporating videorecording of skills, multi-source feedback using assessment tools with validity evidence, and sequential deliberate practice was piloted in a single-center, prospective study at the University of Rochester. Study participants included eight second-year psychiatry residents and 23 third-year clerkship students. After an introduction to foundational feedback concepts in didactic sessions, residents were videorecorded providing feedback to medical students. Recordings were reviewed with a faculty member for feedback. Skills were assessed by students who had received resident feedback, residents, and faculty utilizing a tool with validity evidence. Observations were repeated a total of three times.

Results

Mean feedback scores increased from 2.70 at the first feedback observation, to 2.77 at the second feedback observation, to 2.89 at the third feedback observation (maximum 3.00 points). The differences between the first and third sessions (0.19) and second and third sessions (0.12) were statistically significant (p values were < .001 and .007, with SE of 0.4 and 0.4, respectively).

Conclusions

The observed competency-based feedback skills training program for residents using sequential, multi-source review and feedback was feasible and effective. Direct observation is a key component of high-quality feedback, and videorecording is an efficient methodology for observations, enabling both direct observation by the assessor and opportunity for enhanced self-assessment by residents viewing themselves in the feedback encounter.

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Data Availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at the University of Rochester.

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Correspondence to Laura Cardella.

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Cardella, L., Lang, V., Cross, W. et al. Applying a Competency-Based Medical Education Framework to Development of Residents’ Feedback Skills. Acad Psychiatry (2024). https://doi.org/10.1007/s40596-024-01973-z

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