Sample quotations supporting clinical performance feedback well-being model
| Feedback variables | Example quotation(s) |
| Perceived purpose of feedback | ‘The most important thing I can say is the system from which the messages come in are as important as the messages, probably more important than the messages themselves… I think you just have to look at the system and say, ‘Here’s the system that we’re providing. What’s the intention of it?’ And at the end of the day, the intention is everything.’ AdultHosp1 ‘I do think that it could be helpful to people’s well-being to know… somebody set it up so that I can see how I’m doing so that I can set goals and improve and feel good about that.’ PedsPCP7 |
| Feedback content | ‘We do get documentation queries and… I think most people find them as an annoyance… I guess in some ways that is documentation feedback.’ AdultHosp5 |
| Feedback validity | ‘A [clinical] note hasn’t even come to me [for signature] and I had to send multiple emails, and there was some error… And the fact that you have to get this full [email] saying… ‘If you don’t do this tonight, you’ll be suspended on Thursday.’ No one wants to see that.’ AdultHosp1 |
| Feedback actionability | ‘What does this number even mean?… Why did that person not recommend me? What was that encounter like? What could I have done differently?… So that, to me, also is not very useful feedback… While high numbers make you feel good and low numbers make you feel bad, ultimately, [they] aren’t very useful in thinking about what I’m doing right or wrong.’ AdultPCP6 |
| Feedback delivery | |
| Non-punitive | ‘I think I kind of mentioned it depends on how feedback is deployed, I guess, if it feels like a punitive thing and stuff, of course, it’s not going to help your well-being and it makes you kind of question. So I think it’s really delicate, it’s a delicate line to walk in terms of being able to convey that feedback is meant for improvement vs it being punitive, I guess.’ AdultHosp5 |
| Includes reinforcing feedback | ‘I think when you get positive feedback… it makes you feel good. And so that’s always helpful because if you’re slugging away at things… I mean academic medicine is so funny where we’re like martyrs, like, you know, it’s not for the money, I guess, (it’s) for the praise.’ PedsPCP2 ‘I think it’s been really helpful to hear both reinforcing and corrective feedback. I think you need to have both.’ PedsHosp6 |
| Recipient variables | |
| Feedback expectations | ‘I think in terms of the lack of overall feedback, I think for me personally it’s very expected, I guess… So I don’t know how much it really affects me.’ AdultPCP3 |
| Reliance on self-assessment | ‘I’m sorry, I don’t really care that much about feedback anymore because I know myself so well now… Since I know myself so well, I usually would not be bothered that much, but when I was younger, I would take it so seriously and personally that I would get depressed and sad for a long time. I felt like I lost my confidence. I lost my self-esteem. But, with getting older, I know where I stand. I know exactly what I’m doing. It never bothered me again.’ AdultPCP7 |
| Reliance on external assessment | ‘It creates a sense of insecurity when you don’t know how you’re doing. And when you only get feedback rarely, it increases your fear of getting feedback.’ PedsPCP1 |
AdultHosp, adult hospital medicine; AdultPCP, adult primary care; PedsHosp, paediatric hospital medicine; PedsPCP, paediatric primary care.