Cost-effectiveness of faculty physician incentives for resident feedback [abstract]
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Study Objectives: EM residents in the US must attain pre-determined educational milestones set forth by ACGME for graduation. Faculty-generated feedback has been shown to improve residents’ progression toward these ends. Unfortunately, feedback quality has often been lacking in residency education. Our EM residency introduced cards completed by faculty at end of shift to highlight and hopefully improve direct feedback given to residents, but initial use by faculty was inconsistent. In response to resident-perceived deficiencies in end-of-shift feedback, small annual financial incentives were offered for improved percentage of end-of-shift cards completed (as a proxy for feedback quantity) as well as resident-rated quality of each faculty physician’s end-of-shift feedback. The aim of this study was to determine if faculty-directed financial incentives improved shift card completion percentage and resident-perceived
quality of faculty-to-resident feedback. Methods: In this IRB-approved retrospective observational study, feedback was compared pre- and post-implementation of a financial bonus policy. Eligible faculty were employed throughout a one-year time period before and after implementation of the incentive (n¼24). Quantity of feedback was calculated as the number of cards completed per shift worked with at least one resident. Quality of feedback was determined from annual surveys asking residents to rate the quality of feedback received from each faculty member over the previous year on a scale from 1-9. The average faculty score before and after incentive implementation was determined and compared. Results: Mean percentage of shift cards completed was significantly higher postincentive (M ¼ 129.51%, SD ¼ 42.82) compared to pre-incentive (M ¼ 26.54%, SD ¼ 41.69), p < .01. Mean resident-perceived feedback quality scores were similar preincentive (M ¼ 7.52, SD ¼ 0.63) and post-incentive (M ¼ 7.71, SD 0.57), p ¼ 0.66. Conclusion: This financial incentive is associated with significantly increased quantity of end-of-shift card completion, but no difference in resident-perceived quality of end-of-shift feedback.