Abstract Title
Types of potential biases within upward feedback assessments of medical training

Authors

Anli Yue Zhou & Paul Baker

Theme

The Teacher

INSTITUTION

Royal Bolton Hospital, Manchester, United Kingdom
North Western Deanery, United Kingdom

Background

Upward feedback has been acknowledged and adopted by many private sector firms1
 
General Medical Council regulate UK medical training2 and has adopted  upward feedback to monitor teaching performance as
a quality control of training for trainees
 
Multiple biases exist, thus the accuracy of upward feedback is debatable
Summary of Work

                                                

Summary of Results

•239 articles identified. Within these articles, 35 articles were unavailable or not relevant.

•Table 1 summarises general results

·The most studies were done in the United States (n=116)

Most studies evaluated trainers or training, were for formative purposes and presented quantitative data (figures 1 and 2)

Most commonly used evaluation tool was paper survey and closed questions were frequently used within the survey (figures 1 and 2)

•Average duration of the study was 18 months

•Average number of participants: 1674

•Average response rate: 76% 

Table 1 General summary of results

Figure 1 Top row: Left- Data type, Right- Purpose of study, Bottom row: Left- Kirkpatrick levels, Right- Type of evaluation used 

Figure 2 Left: Domain of feedback, Right: Quality of questions used

Table 2 Summary of both overt and implied biases found within the literature

Method of of feedback and motivation were the most common bias that were implied (table 2)

Accountability and confidentiality and the voluntary nature of the survey were the most common biases recognized within the articles 

Conclusion

Most studies on upward feedback bias were evaluative studies and only covered Kirkpatrick level 1-Reaction ( figure 1 )
 
Potential factors affecting upward feedback were not recognised within studies which could have skewed results
 
Upward feedback does have a role in evaluating medical training and trainers and lead to improvements
 
Triangulation of different feedback methods can optimise training quality
 
More support and transparency is required to reduce upward feedback bias
 
Further research is required that goes beyond Kirkpatrick level 1 to assess effectiveness of upward feedback
 
 
Take-home Messages

Upward feedback can improve ratee performance, but methods in reducing bias may be affected by financial and time constraints

References

1.Hall JL, Leidecker JK, DiMarco C. What we know about upward appraisals of management: Facilitating the future use of UPAs. Human Resource Development Quarterly 1996; 7(3): 209-26.
2.General Medical Council. The GMC Quality Framework for specialty including GP training in the UK 2010. Available from http://www.gmc-uk.org/6___PMETB_Merger___Governance_Standards_and_Policies___Annex_D.pdf_36036849.pdf [accessed 27/6/13] 
Background
Summary of Work
Summary of Results
Conclusion
Take-home Messages
References
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