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A Randomized Controlled Trial

William B. Brinkman, MD, MEd; Sheela R. Geraghty, MD, MS; Bruce P. Lanphear, MD, MPH; Jane C. Khoury, PhD; Javier A. Gonzalez del Rey, MD; Thomas G. DeWitt, MD; Maria T. Britto, MD, MPH

Arch Pediatr Adolesc Med. 2007;161(1):44-49.

Objective  To determine whether augmenting standard feedback on resident performance with a multisource feedback intervention improved pediatric resident communication skills and professionalism.

Design  Randomized controlled trial.

Setting  Children's Hospital Medical Center, Cincinnati, Ohio, from June 21, 2004, to July 7, 2005.

Participants  Thirty-six first-year pediatric residents.

Interventions  Residents assigned to the multisource feedback group (n = 18) completed a self-assessment, received a feedback report about baseline parent and nurse evaluations, and participated in a tailored coaching session in addition to receiving standard feedback. Residents in the control group (n = 18) received standard feedback only. The control group and their residency directors were blinded to parent and nurse evaluations until the end of the study.

Main Outcome Measures  Residents' specific communication skills and professional behaviors were rated by parents and nurses of pediatric patients. Both groups were evaluated at baseline and after 5 months. Scores were calculated on each item as percentage in the highest response category.

Results  Both groups had comparable baseline characteristics and ratings. Parent ratings increased for both groups. While parent ratings increased more for the multisource feedback group, differences between groups were not statistically significant. In contrast, nurse ratings increased for the multisource feedback group and decreased for the control group. The difference in change between groups was statistically significant for communicating effectively with the patient and family (35%; 95% confidence interval, 11.0%-58.0%), timeliness of completing tasks (30%; 95% confidence interval, 7.9%-53.0%), and demonstrating responsibility and accountability (26%; 95% confidence interval, 2.9%-49.0%).

Conclusion  A multisource feedback intervention positively affected communication skills and professional behavior among pediatric residents.

Trial Registration  Clinicaltrials.gov Identifier: NCT00302783

Author Affiliations: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

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