Effect of an educational intervention on faculty and resident satisfaction with real-time feedback in the emergency department

Objectives: Effective real-time feedback is critical to medical education. This study tested the hypothesis that an educational intervention related to feedback would improve emergency medicine (EM) faculty and resident physician satisfaction with feedback. Methods: This was a cluster-randomized, controlled study of 15 EM residency programs in 2007-2008. An educational intervention was created that combined a feedback curriculum with a card system designed to promote timely, effective feedback. Sites were randomized either to receive the intervention or to continue their current feedback method. All participants completed a Web-based survey before and after the intervention period. The primary outcome was overall feedback satisfaction on a 10-point scale. Additional items addressed specific aspects of feedback. Responses were compared using a generalized estimating equations model, adjusting for confounders and baseline differences between groups. The study was designed to achieve at least 80% power to detect a one-point difference in overall satisfaction (α = 0.05). Results: Response rates for pre- and postintervention surveys were 65.9 and 47.3% (faculty) and 64.7 and 56.9% (residents). Residents in the intervention group reported a mean overall increase in feedback satisfaction scores compared to those in the control group (mean increase 0.96 points, standard error [SE] ± 0.44, p = 0.03) and significantly higher satisfaction with the quality, amount, and timeliness of feedback. There were no significant differences in mean scores for overall and specific aspects of satisfaction between the faculty physician intervention and control groups. Conclusions: An intervention designed to improve real-time feedback in the ED resulted in higher resident satisfaction with feedback received, but did not affect faculty satisfaction with the feedback given.