title: Barriers and Facilitators to Effective Feedback: A Qualitative Analysis of Data From Multispecialty Resident Focus Groups.
abstract: BACKGROUND
  Despite the importance of feedback, the literature suggests that there is inadequate feedback in graduate medical education.
  
  
  OBJECTIVE
  We explored barriers and facilitators that residents in anesthesiology, emergency medicine, obstetrics and gynecology, and surgery experience with giving and receiving feedback during their clinical training.
  
  
  METHODS
  Residents from 3 geographically diverse teaching institutions were recruited to participate in focus groups in 2012. Open-ended questions prompted residents to describe their experiences with giving and receiving feedback, and discuss facilitators and barriers. Data were transcribed and analyzed using the constant comparative method associated with a grounded theory approach.
  
  
  RESULTS
  A total of 19 residents participated in 1 of 3 focus groups. Five major themes related to feedback were identified: teacher factors, learner factors, feedback process, feedback content, and educational context. Unapproachable attendings, time pressures due to clinical work, and discomfort with giving negative feedback were cited as major barriers in the feedback process. Learner engagement in the process was a major facilitator in the feedback process.
  
  
  CONCLUSIONS
  Residents provided insights for improving the feedback process based on their dual roles as teachers and learners. Time pressures in the learning environment may be mitigated by efforts to improve the quality of teacher-learner relationships. Forms for collecting written feedback should be augmented by faculty development to ensure meaningful use. Efforts to improve residents' comfort with giving feedback and encouraging learners to engage in the feedback process may foster an environment conducive to increasing feedback.
authors.forename: Shalini T
authors.initials: ST
authors.lastname: Reddy
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Zegarek
authors.forename: H Barrett
authors.initials: HB
authors.lastname: Fromme
authors.forename: Michael S
authors.initials: MS
authors.lastname: Ryan
authors.forename: Sarah-Anne
authors.initials: SA
authors.lastname: Schumann
authors.forename: Ilene B
authors.initials: IB
authors.lastname: Harris
mesh_terms: D001291:Attitude of Health Personnel; D005246:Feedback; D005260:Female; D017144:Focus Groups; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007858:Learning; D008297:Male; D008511:Medicine; D036301:Qualitative Research; D013997:Time Factors