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Simple feedback notes enhance specificity of feedback to learners.

BACKGROUND
Learners reported that physician educators give insufficient and general feedback.


OBJECTIVE
This study analyzed faculty's use of 3 x 5-inch feedback notes (preprinted with "well done" or "needs improvement") for quantity and specificity of feedback. Learners evaluated these notes compared with other feedback methods.


DESIGN/METHODS
Seven experienced clinician educators presented the feedback notes to learners during the 10-month trial. A carbonless duplicate was retained for qualitative analysis of content. The specificity of comments was categorized as general (no clarifiers) or detailed if it contained 1 or more clarifiers. Additionally, the learners were surveyed regarding utility of notes on the basis of characteristics of effective feedback.


RESULTS
A total of 770 notes containing 1607 individual comments were presented to learners, with significantly more (P <.001) "well done" comments (69%) than "needs improvement" comments (31%). Eleven content areas emerged. The most frequently coded "well done" content areas were assessment (n = 258), treatment (n = 208), and physical examination (n = 176). The most frequently coded "needs improvement" content areas were documentation (n = 161) and expanding knowledge (n = 102). Eighty-two percent of the comments were specific, and the specificity increased significantly from 24% in the initial 4-month time frame to 46% in the last 3 months (P <.001, Pearson chi-square test). Learners agreed that feedback notes provided more constructive (94%), timely (92%), and concrete (94%) feedback when compared with other feedback methods. Learners preferred feedback given face-to-face (96%) or by written notes (96%) rather than by e-mail (30%).


CONCLUSIONS
Cued feedback notes provided learners with detailed feedback in a format that learners prefer. Over time, simple feedback notes lead to more specific feedback for trainees.