BENEFICIAL AND HARMFUL EFFECTS OF AUGMENTED FEEDBACK ON PHYSICIANS CLINICAL-TEACHING PERFORMANCES

Purpose, To evaluate whether clinical-teaching skills could be improve d by providing teachers with augmented student feedback, Method. A ran domized, controlled trial in 1994 included 42 attending physicians and 39 residents from the Department of Medicine at the Indiana Universit y School of Medicine who taught 110 students on medicine ward rotation s for one-month periods. Before teaching rotations, intervention group teachers received norm-referenced, graphic summaries of their teachin g performances as rated by students. At mid-month, intervention group teachers received students' ratings augmented by individualized teachi ng-effectiveness guidelines based on the Stanford Faculty Development Program framework. Linear models were used to analyze the students' me an ratings of teaching behaviors at mid-month and end-of-month, Indepe ndent: variables included performance ratings, intervention status, te acher status, teaching experience, and interactions with baseline rati ngs, Results. Complex interactions with baseline performance were foun d for most teaching categories at mid-month and end-of-month. The inte rvention-group teachers who had high baseline performance scores had h igher student ratings than did the control group teachers with similar baseline scores; the intervention group teachers who had low baseline performance scores were rated lower than were the control group teach ers with comparable baseline scores. The residents who had medium or h igh baseline stores were rated higher than were the attending physicia ns with comparable baseline scores; the performance of the residents w ho had low baseline scores was similar to that of the attending physic ians with comparable baseline scores. Conclusion, Baseline performance is important for targeting those teachers most likely to benefit from augmented student feedback, Potential deterioration in teaching perfo rmance warrants a reconsideration of distributing students' ratings to teachers with low baseline performance scores.