Medical students' perceptions of feedback in a busy ambulatory setting: a descriptive study using a clinical encounter card.

摘要

BACKGROUND: Residents and medical students have expressed repeated concerns over the years about the inadequate amounts and quality of feedback in the clinical setting. Despite innovative ways to teach the skill of giving feedback, the problem has not been fixed. METHODS: In this study, the author introduced the clinical encounter card to the ambulatory setting for faculty to use as a cue to provide feedback to students. At the end of the 4-week rotation, students anonymously reported on the amount, frequency, and quality of feedback they received. RESULTS: Students reported that the learning climate for giving/receiving feedback was very good to excellent. They rated the quality and amount of feedback they received from faculty as high on the Likert scale and the frequency just above the mean. Most of the feedback was directed toward knowledge and skills, and there were few reports of demeaning behavior. Feedback was timely, and students reported using the feedback to improve their performance. The clinical encounter card improved feedback to students in a busy ambulatory setting. Whereas the author did not monitor how often the clinical encounter card was used, there were ample cards on each student to provide mid-rotation feedback and summative evaluations. The students rated the process as the best of any clerkship rotation. CONCLUSIONS: The clinical encounter card is an effective tool to enhance feedback in a busy pediatric ambulatory setting. It is not known if these results are generalizable, but readers are encouraged to repeat the study in other settings.