Assessment of neurosurgical resident milestone evaluation reporting and feedback processes

OBJECTIVE Structured performance evaluations are important for the professional development and personal growth of resident learners. This process is formalized by the Accreditation Council for Graduate Medical Education milestones assessment system. The primary aim of this study was to understand the current feedback delivery mechanism by exploring the culture of feedback, the mechanics of delivery, and the evaluation of the feedback itself. METHODS Face-to-face interviews were conducted with 10 neurosurgery residents exploring their perceptions of summative feedback. Coded data were analyzed qualitatively for overriding themes using the matrix framework method. A priori themes of definition of feedback, feedback delivery, and impact of feedback were combined with de novo themes discovered during analysis. RESULTS Trainees prioritized formative over summative feedback. Summative and milestone feedback were criticized as being vague, misaligned with practice, and often perceived as erroneous. Barriers to implementation of summative feedback included perceived veracity of feedback, high interrater variability, and the inconstant adoption of a developmental progression model. Gender bias was noted in degree of feedback provided and language used. CONCLUSIONS Trainee perception of feedback provided multiple areas of improvement. This paper can serve as a baseline to study improvements in the milestone feedback process and optimize learning. https://thejns.org/doi/abs/10.3171/2022.1.FOCUS21734

Automated summary

This study aims to understand neurosurgery residents' perceptions of summative feedback and the factors influencing it. The study found that trainees prioritize formative feedback and criticized the vagueness and misalignment with practice of summative feedback. Barriers to implementing summative feedback include its perceived veracity, high interrater variability, and inconsistent adoption of a developmental progression model. Gender bias was also noted in the degree of feedback provided and language used.