Explaining how faculty members act upon residents' feedback to improve their teaching performance

Responsiveness to feedback is a complex phenomenon that requires and receives attention. However, knowledge on the responsiveness of faculty members to residents' feedback on their teaching performance is lacking. Excellent teaching performance is essential to ensure patient safety and residents' learning in residency training. This study aims to increase our understanding of how faculty staff react to and act upon residents' feedback on their teaching performance. This multi-specialty, multi-institution interview study was conducted to gain insight into: (i) how teaching faculty proceed after they have received residents' feedback on their teaching performance, and (ii) the factors that influence their progression. Between August and December 2011, 24 faculty members who had received formative feedback on their teaching performance through valid and reliable feedback systems participated in this study. They reflected upon their (re)action(s) during individual semi-structured interviews. The interview protocol and analysis were guided by a comprehensive transtheoretical framework describing and explaining stages and processes of behavioural change. Faculty staff involved in residency training used residents' feedback to different extents to adapt or improve their teaching performance. Important tipping points in the processes of change necessary for faculty staff to put feedback into practice were: experiencing negative emotions in themselves or recognising those in residents as a result of failure to act upon feedback; realising that something should be done with or without support from others, and making a strong commitment to change. In addition, having the confidence to act upon feedback and recognising the benefits of change were found to stimulate faculty members to change their teaching behaviour. The responsiveness of faculty members to residents' feedback on their teaching performance varies. The adapted transtheoretical framework explains how and why faculty members do or do not proceed to action after receiving residents' feedback. Given this, organising residents' feedback for faculty staff in a systematic way is a first step and is necessary to effect potential improvements in teaching performance