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Exploring residents’ reactions to and use of parent feedback in a pediatric emergency department: A grounded theory study

Abstract Background: Competency-based medical education (CBME) involves workplace-based assessment. In pediatrics, patients’ parents can participate in this assessment and generate feedback for residents. Prior to routinely collecting parent feedback, it is important to investigate residents’ perspectives on it. Aim: To explore residents’ reactions to and use of written parent feedback. Methods: Using a grounded theory approach, we interviewed residents who received written parent feedback at the mid- and end-points of a pediatric emergency training rotation. Results: Twenty-five residents participated. The residents reacted positively to the feedback. They thought that it complements educators’ feedback, can elucidate parents’ perspectives and needs, and is something that residents want and need. Although the residents thought that non-specific negative parent feedback is not useful, they believed non-specific positive and constructive parent feedback to be encouraging and useful. They delineated how they use non-specific positive parent feedback to boost their self-confidence and reassure themselves that parents perceive their clinical practices as appropriate. They also elucidated how they use constructive parent feedback to understand what is important to parents, become aware of their own behaviors, and modify their clinical practices. Conclusions: The findings encourage educators in pediatrics to include parents in resident assessment, especially in the CBME era.