The Challenges of Multisource Feedback: Feasibility and Acceptability of Gathering Patient Feedback for Pediatric Residents

The Accreditation Council for Graduate Medical Education calls for residency programs to incorporate multisource feedback, which may include patient feedback, into resident competency assessments. Program directors face numerous challenges in gathering this feedback. This study assesses the feasibility and acceptability of patient feedback collection in the inpatient and outpatient setting at 3 institutions. Patient feedback was collected using a modified version of the Communication Assessment Tool (CAT). Trained research assistants administered the CAT to eligible patients and families in pediatric ward, intensive care, and outpatient settings from July to October 2015. Completion rates and reasons for non-completion were recorded. Patient satisfaction with the CAT was assessed on a 5-point Likert scale. The CAT was completed by 860/1413 (61%) patients. Completion rates in the pediatric ward and intensive care settings were 45% and 38%, respectively, compared to 91% in the outpatient setting. In inpatient settings, survey non-completion was typically due to participant unavailability; this was rarely a reason in the outpatient setting. A total of 93.4% of patients were satisfied or very satisfied with using the CAT. It was found that 6.36 hours of research assistant time would be required to gather a valid quantity of patient feedback for a single resident in the outpatient setting, compared to 10.14 hours in the inpatient setting. Although collecting feedback using our standardized protocol is acceptable to patients, obtaining sufficient feedback requires overcoming several barriers and a sizable time commitment. Feedback collection in the outpatient setting may be higher yield than in the inpatient setting due to greater patient/family availability. Future work should focus on innovative methods to gather patient feedback in the inpatient setting to provide program directors with a holistic view of their residents’ communication skills.