Regular evaluations, Dr. Bhatti said, provide attending surgeons with a framework for giving residents formative feedback. “Summative feedback is, ‘You did a good job, I’m proud of you,’” he said. “Formative feedback is, ‘These are the good things you did well, and these are the things we need to work together to improve, and this is how you should improve.’”
Explore This IssueDecember 2014
Because providing reviews after every surgery can become cumbersome, Dr. Bhatti said the members of his team at Johns Hopkins only complete them for certain surgeries that occur at the start of the rotation, in the middle, and at the end. “There’s less of a burden on evaluators who are busy practitioners,” he said.
Dr. Rowland suggested otolaryngologists take a cue from the airline industry, which asks crew members to do a two-minute debriefing after every flight to determine what went well and what didn’t. After every surgery, she said, the attending should ask the resident, “How do you think you did? What do you think you improved on during this surgery?” For their part, residents should turn to the attending and ask, “How can I do better next time?” “It shows respect for the teacher and gives student something to focus on,” she said.
Make It a Group Effort
It’s also a good strategy to let other staff members—including nurses, nurse practitioners, and physicians assistants—evaluate residents, Dr. Bhatti said. That way, they get a 360-degree view of how well they work with other team members.
Dr. Rowland said such evaluations can also present an opportunity to discuss the resident’s communication skills. “The attending may say, ‘You’re competent. You were able to perform at a level appropriate for PGY3, but other staff said you could have been kinder to the circulating nurse,’” she explained.
Share Best Practices
Most importantly, educators should publish summaries about the evaluation strategies and tools that work so that other programs don’t find themselves having to reinvent the wheel, Dr. Bhatti added. “We should be sharing our experiences through literature and communication across programs. It’ll make life for the program director much easier if others share their resources,” he said.
Stephanie Mackiewicz is a freelance medical writer based in California.