title: A Feedback and Evaluation System That Provokes Minimal Retaliation by Trainees.
abstract: Grade inflation is pervasive in educational settings in the United States. One driver of grade inflation may be faculty concern that assigning lower clinical performance scores to trainees will cause them to retaliate and assign lower teaching scores to the faculty member. The finding of near-zero retaliation would be important to faculty members who evaluate trainees.
  
  
  
  The authors used a bidirectional confidential evaluation and feedback system to test the hypothesis that faculty members who assign lower clinical performance scores to residents subsequently receive lower clinical teaching scores. From September 1, 2008, to February 15, 2013, 177 faculty members evaluated 188 anesthesia residents (n = 27,561 evaluations), and 188 anesthesia residents evaluated 204 faculty members (n = 25,058 evaluations). The authors analyzed the relationship between clinical performance scores assigned by faculty members and the clinical teaching scores received using linear regression. The authors used complete dyads between faculty members and resident pairs to conduct a mixed effects model analysis. All analyses were repeated for three different epochs, each with different administrative attributes that might influence retaliation.
  
  
  
  There was no relationship between mean clinical performance scores assigned by faculty members and mean clinical teaching scores received in any epoch (P ≥ 0.45). Using only complete dyads, the authors' mixed effects model analysis demonstrated a very small retaliation effect in each epoch (effect sizes of 0.10, 0.06, and 0.12; P ≤ 0.01).
  
  
  
  These results imply that faculty members can provide confidential evaluations and written feedback to trainees with near-zero impact on their mean teaching scores.
authors.affiliation: From the Harvard Medical School, Boston, Massachusetts; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts (K.B.); Division of Pediatric Anesthesia, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan (B.H.); and Samuel Curtis Johnson Graduate School of Management, Cornell University, Ithaca, New York (S.M.).
authors.forename: Keith
authors.initials: K
authors.lastname: Baker
authors.forename: Bishr
authors.initials: B
authors.lastname: Haydar
authors.forename: Shawn
authors.initials: S
authors.lastname: Mankad
mesh_terms: D000776:Anesthesiology / Q000193:education*; D004521:Educational Measurement / Q000379:methods* / Q000706:statistics & numerical data; D005180:Faculty, Medical / Q000706:statistics & numerical data*; D000068156:Formative Feedback; D006801:Humans; D007396:Internship and Residency; D008404:Massachusetts; D013337:Students, Medical