title: Integrating Postoperative Feedback Into Workflow: Perceived Practices and Barriers.
abstract: OBJECTIVE
  Previous studies have found that both resident and staff surgeons highly value postoperative feedback; and that such feedback has high educational value. However, little is known about how to consistently deliver this feedback. Our aim was to understand how often surgical residents should receive feedback and what barriers are preventing this from occurring.
  
  
  METHODS
  Surveys were distributed to resident and attending surgeons. Questions focused on the current frequency of postoperative feedback, desired frequency and methods of feedback, and perceived barriers. Quantitative data were analyzed with descriptive statistics, and text responses were examined using coding.
  
  
  METHODS
  University-based general surgery department at a Midwestern institution.
  
  
  METHODS
  General surgery residents (n = 23) and attending surgeons (n = 22) participated in this study.
  
  
  RESULTS
  Residents reported receiving and staff reported giving feedback for procedure-specific performance after 25% versus 34% of cases, general technical feedback after 36% versus 32%, and nontechnical performance after 17% versus 18%. Both perceived procedure-specific and general technical feedback should be given more than 80% of the time, and nontechnical feedback should happen for nearly 60% of cases. Verbal feedback immediately after the operation was rated as best practice. Both parties identified time, conflicting responsibilities, lack of privacy, and discomfort with giving and receiving meaningful feedback as barriers.
  
  
  CONCLUSIONS
  Both resident and staff surgeons agree that postoperative feedback is given far less often than it should. Future work should study intraoperative and postoperative feedback to validate resident and attending surgeons' perceptions such that interventions to improve and facilitate this process can be developed.
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Jay N
authors.initials: JN
authors.lastname: Nathwani
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Carly E
authors.initials: CE
authors.lastname: Glarner
authors.affiliation: Department of Industrial and Systems Engineering, University of Wisconsin School of Engineering, Madison, Wisconsin.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Law
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McDonald
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Zelenski
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Greenberg
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address: foleyc@surgery.wisc.edu.
authors.forename: Eugene F
authors.initials: EF
authors.lastname: Foley
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000379:methods; D030141:Feedback, Psychological; D005260:Female; D013502:General Surgery / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital; D010465:Perception; D011184:Postoperative Period; D011795:Surveys and Questionnaires; D014922:Wisconsin; D057188:Workflow
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Professionalism; feedback in surgery; post-operative work flow; postoperative feedback; surgical education