Ian . Chua,Stanford University School of Medicine,Palo Alto,CA,Alyssa Bogetz,Stanford University School of Medicine,Palo Alto ,CA,Alice Hensley,Stanford University School of Medicine,Palo Alto,CA,Rebecca Blankenburg,Stanford University School of Medicine,Palo Alto,CA,Elizabeth Stuart,Stanford University School of Medicine,Palo Alto,CA
Background: Most structured patient feedback for medical students comes from Standardized Patients in preclinical years but there are few standard processes for solicitation of patient feedback in clerkships.
Objective: To examine medical student perceptions on the impact of soliciting constructive patient feedback on their relationship with patients and potential new approaches in obtaining patient feedback for medical students.
Design/Methods: All medical students who completed their pediatric core clerkship were eligible to participate. Medical students were randomly selected and emailed invitations. Participants took part in a 60-minute focus group exploring clerkship students’ prior experiences soliciting patient feedback, perceptions of “meaningful patient feedback,” the perceived impact on the student-patient relationship, and suggestions for an ideal process of obtaining constructive patient feedback. Themes were identified through an iterative approach using principles of grounded theory.
Results: Ten medical students participated with all participants completing the Stanford Pediatric Clerkship within the last two years, which required distribution of at least one patient feedback form to pass the clerkship with distinction. Thematic analysis revealed (1) medical student discomfort in direct solicitation of feedback through forms due to accentuation of their “student status” and not blending in with the team, (2) difficulty asking for “honest” and “constructive” feedback due to perceived conflict of interest and erosion of built trust with patients, (3) a general indifference to positive patient feedback, and (4) a belief that unsolicited feedback on medical student or team performance is the most helpful to learning. Participants suggested three strategies: (1) team-based methods of soliciting patient feedback (e.g. attending/resident asking on behalf of student), (2) empowering patients as teachers, and (3) specific statement of learner goals to patients to help frame constructive feedback from patients.
Discussion: Clerkship requirements and forms may facilitate patient feedback, but may not be meaningful for learners without appropriate context and framing for patients who likely have no experience in providing feedback possibly disrupting the patient-student relationship. Approaches that empower and teach patients to give constructive feedback may improve feedback quality and comfort of both the medical student and patient in the feedback process.