Perspectives of Family Medicine Clerkship Directors Regarding Forward Feeding: A CERA Study

Forward feeding signifies sharing information about learners for purposes of professional and academic advancement, and promotes progression toward a competency-based educational continuum. The aim of this study is to assess reasons for difficulty or failure of the family medicine clerkship and investigate utilization and methods of forward feeding. Reasons behind medical school policies regarding forward feeding are also evaluated. Data were collected through the 2013 Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) Family Medicine Clerkship Director survey. Directors rated reasons for clerkship difficulty or failure on a 6-point Likert scale. They also reported if they utilized forward feeding, to whom, and the communication method used. Finally, they were asked about factors influencing institutional policy toward forward feeding, including threats of litigation. RESULTS were compared between public and private schools, and based on tenure as clerkship director. Analyses were performed using chi-square or Fisher's exact test. Knowledge deficits were the most common reason for clerkship difficulty and failure, followed by professionalism difficulties. Over half of respondents engage in forward feeding, and almost all pass this information to other clerkship directors. Concern for student privacy and faculty bias were noted as two important factors influencing school policy. While almost half of respondents felt that litigation fears influenced their school's approach to forward feeding, few were aware of any related litigation. Forward feeding is only utilized by half of clerkship directors. More studies regarding the potential impacts of this practice are warranted.