Title

Development of a guide by postgraduate residents on receiving feedback from faculty in the operating theatre at Aga Khan University Hospital

Date of Award

5-30-2015

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Dr. Abdulkarim Abdallah

Second Supervisor/Advisor

Dr. Dorothy Kamya

Department

General Surgery (East Africa)

Abstract

Background: Direct observation of residents in clinical encounters by faculty and assessment for learning has now become a key component of postgraduate training programs. DOPS, a workplace-based assessment form, was designed to provide formative assessment and feedback about a trainee’s procedural skills. Interactions between residents and faculty are central to this learning process and are influenced by multiple factors both at faculty and resident levels as well as contextual factors. The feedback may be used by the receiver to contemplate behaviour change. The receptivity of the resident to the feedback is a key determinant as to whether the process to permanent behaviour change (learning) will occur. Studies have shown discordance between intended feedback by faculty and that received by trainees. It has been noted that top-down approaches to improve receptiveness of feedback have little influence on students’ experience. Tips for trainees have been proposed to make best use of feedback which provide strategies to reflect, interact and respond to feedback from faculty. These tips are numerous to memorize and recall, overlapping in their composition and not specific for the Aga Khan University setting. This study sought to locally-develop the AKUH O.R Feedback tips, a resident driven action research tool based on the twelve tips, to improve receptivity of feedback from faculty at AKUHN.

Objective: To develop a feedback guide that postgraduate residents can use to improve their receptivity of feedback received from faculty in the operating theatre after a directly observed procedural skill at Aga Khan University Hospital, Nairobi.

Design: A Qualitative action research study.

Method: Consented first-year residents from general surgery, anesthesiology, obstetrics and gynecology underwent direct observation in the operating room by faculty after which they received feedback. They then participated in focus group discussions lasting 90-120 minutes during which they expressed their feelings and perceptions towards their feedback, identified problems and proposed remedies. The discussions were audio recorded, transcribed verbatim, verified, anonymized and analyzed using NVIVO 10 software. Giorgi phenomenological qualitative method was used to develop themes. They were then introduced to the “twelve tips of making the best use of feedback” as compiled by Van der Leeuw and Slootweg during interactive workshop. They reflected on their experience, identified with and modified the tips to best suit the academic and workplace environment at Aga Khan University Hospital operating theatre. The AKUHN Feedback tips were formulated and their response to the guide was then analyzed.

Results: The residents at AKUHN had a broad understanding of the concept of feedback. They were familiar with the ideal qualities of good feedback. Their experience with the ‘Twelve tips’ triggered the development of SORTeD Feedback guide. The guide improved receptivity, ability to reflect with a guideline and formulate a road map for action.

Conclusion: This study developed a resident-driven guide that has increased receptivity and use of feedback from faculty by postgraduate residents in the operating room at AKUHN. It further demonstrates the guide’s potential use for other feedback encounters outside the operating room.

This document is available in the relevant AKU library

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