Mid-rotation feedback provides radiology trainees with timely evaluations

Feedback is a widely discussed topic among radiologists. The advent of peer learning programs has “changed the game” with regards to radiologists providing feedback to their peers and colleagues. But what about feedback for radiology trainees? A new case study published in the Journal of the American College of Radiology detailed the concept of mid-rotation feedback and its potential benefits. 

“If studying medicine without books is like sailing an uncharted sea, learning radiology without individualized correction is like learning how to sail without a captain,” wrote authors Matthew A. Morgan, MD and Lisa P. Jones, MD, PhD, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. “Constructive critiques during a rotation keep the trainee on course and lead to improved trainee satisfaction with the learning experience.”

But, the authors ask, is all feedback the same? What can make it more effective?

Morgan and Jones noted two types of feedback: (1) the formative type, which is a “constant stream” of feedback about particular cases and (2) the summative type, which is traditionally given at the end of a rotation and consists of Likert-score questions and a free-text box. However, the researchers noted, standardized evaluations, like the summative feedback, are seen as “nonspecific” and also “lack points for concrete improvement.”

The solution, they note, is mid-rotation feedback. The chief benefit of providing feedback at the middle of a rotation is its timing.

“Mid-rotation evaluations have been shown to help teachers better manage the expectations of a course, and feedback that arrives sooner than the end of the rotation allows the trainee a chance to fix problem areas before it is too late,” the authors wrote. “Younger generations of radiology trainees also value quicker turnaround time for feedback.”

End-of-rotation feedback is generally viewed as “late to the game,” the researchers said. By the time the feedback reaches to the recipient, they may already be on a different rotation.

Another benefit to mid-rotation feedback is that it gives program organizers a chance to amend their system in the event there are challenges in the learning environment or interpersonal issues between instructors and students.

“The quicker turnaround time in improving the learning environment can only improve the learning experience,” the authors wrote.

Morgan and Jones noted mid-rotation feedback should not mimic numerical-based evaluations at the end of the rotation. Additionally, the feedback should be more informal in nature and allow for open discussion of learning points. And finally, feedback providers should be aware of “feedback fatigue” as students are provided with a lot throughout several rotations.

To ensure mid-rotation feedback is effective, the researchers noted some best practices.

  1. Feedback providers should communicate when there will be feedback at least a day in advance.
  2. Obtain faculty comments a few days in advance using three open-ended questions that touch on the resident’s overall performance, areas of improvement and the areas where the resident excels.
  3. Trainees should be met one-on-one with a course representative.
  4. The interview should take a maximum of 15 minutes.

“A combination of mid-rotation and end-of-rotation feedback has the potential to better achieve the whole goal of feedback: allowing trainees to more quickly change practice and to practice changes,” the authors concluded. “It also grants faculty quicker insight into training inefficiencies and allows tailoring of a rotation to the individual trainees’ strengths and weaknesses. It keeps the training partnership on a tight course while the trainee learns the ropes.”