2019 HSC Section 2 - Practice Management

ARTICLE IN PRESS

TABLE 6. Taxonomy of VRM Cross-Classi fi ed by Role Dimensions 18 Role Dimension Description

Verbal Response Modes

Attentive

Concern the other person ’ s experiences

4.44 (SD = 0.86). All other descriptors were not signifi- cantly different between SIMPL and in-person feedback. There was no significant difference between third-party assessment scores of feedback given via SIMPL and in- person (mean difference = 1.15, 95% CI = ¡ 2.15 to 4.44, p = 0.49). Results of feedback quality as assessed by the resident survey and the Third-Party Feedback Assess- ment Form are shown in Table 8 . DISCUSSION The goal of our study was to compare the quality and delivery of best-case resident postoperative feedback given via SIMPL with that given in-person. Our results show that the ways in which surgeons spoke when giv- ing feedback using SIMPL were measurably different from the ways in which they spoke when providing feedback in person. When using SIMPL, the feedback was shorter, more directive—containing thoughts, per- ceptions, evaluations of resident behavior, or advice— and contained more presumptuous utterances—in which the physician reflected on and assessed resident performance or offered suggestions for improvement— than in-person feedback. Broadly, this means that when using SIMPL, attendings guided the conversation more, attempted to guide the recipient’s behavior more, and presumed to understand the other’s experience and know what the other should do. Conversely, we found that when surgeons gave feedback in person, the feedback was longer and the surgeons were more acqui- escent and unassuming. This means they asked more questions, responded, restated, and clarified what the resident said more often, and stated more objective facts rather than sharing personal judgments or evaluations. This result is expected; when the medium of communi- cation changes, so does the mode of communication. Feedback given via dictation through a phone is Interpretation (I), Question (Q), Re fl ection (R), Acknowledgment (K) Advisement (A), Disclosure (D), Con fi rmation (C), Edi fi cation (E) Question (Q), Acknowledgment (A), Disclosure (D), Edi fi cation (E) Interpretation (I), Question (Q), Advisement (A), Disclosure (D) Re fl ection (R), Acknowledgment (K), Con fi rmation (C), Edi fi cation (E)

Informative

Concern the speaker ’ s experiences

Presumptuous

Presumes knowledge about the other person Interpretation (I), Re fl ection (R), Advisement (A), Con fi rmation (C)

Unassuming

Does not presume knowledge about the other person Uses the speaker ’ s frame of reference

Directive

Acquiescent

Uses the other ’ s frame of reference

RESULTS SIMPL feedback contained significantly less utterances than in-person feedback (mean difference = ¡ 16.55, 95% CI = ¡ 27.02 to ¡ 6.08, p = 0.003). The mean num- ber of attendings’ utterances was 12.89 (SD = 5.73) for SIMPL feedback and 29.44 (SD = 21.72) for in-person feedback. Chi-square tests for equality of proportions showed feedback intent provided via SIMPL was signifi- cantly more directive than in-person feedback (mean dif- ference = 9.43%, 95% CI = 1.78%-16.81%, p = 0.01) and more presumptuous than in-person feedback (mean dif- ference = 9.21%, 95% CI = 1.59%-16.84%, p = 0.01). Table 7 summarizes the proportions of each Role Dimension. Residents’ scoring of the quality of SIMPL-based vs. in- person feedback revealed no significant difference (mean difference = 2.40, 95% CI = ¡ 0.24 to 5.05, p = 0.07). Broken down by descriptor, resident survey of feedback showed a significant difference (mean differ- ence = 0.50, 95% CI = 0.090-0.92, p = 0.02) on descriptor 4, which was that the feedback “focused on personality” vs. “focused on behaviors.” The mean score of SIMPL feedback on descriptor 4 was 4.95 (SD = 0.23). The mean score of in-person feedback on descriptor 4 was

TABLE 7. Results — Role Dimension Proportions Role Dimension

Attentive 32.24% 30.75% 44.49% 35.28% Directive* 64.90% 55.47%

Informative 67.76% 69.25% Unassuming*

SIMPL

In-Person

Presumptuous*

SIMPL

55.51% 64.72% 35.10% 44.53%

In-Person

Acquiescent*

SIMPL

In-Person

Journal of Surgical Education Volume 00 /Number 00 & 2018

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