Education  |   February 2017
A Feedback and Evaluation System That Provokes Minimal Retaliation by Trainees
Author Notes
  • From the Harvard Medical School, Boston, Massachusetts; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts (K.B.); Division of Pediatric Anesthesia, Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan (B.H.); and Samuel Curtis Johnson Graduate School of Management, Cornell University, Ithaca, New York (S.M.).
  • Submitted for publication March 13, 2016. Accepted for publication November 7, 2016.
    Submitted for publication March 13, 2016. Accepted for publication November 7, 2016.×
  • Address correspondence to Dr. Baker: Department of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114. khbaker@partners.org. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Original Investigations in Education / Education / CPD
Education   |   February 2017
A Feedback and Evaluation System That Provokes Minimal Retaliation by Trainees
Anesthesiology 2 2017, Vol.126, 327-337. doi:10.1097/ALN.0000000000001471
Anesthesiology 2 2017, Vol.126, 327-337. doi:10.1097/ALN.0000000000001471
Abstract

Background: Grade inflation is pervasive in educational settings in the United States. One driver of grade inflation may be faculty concern that assigning lower clinical performance scores to trainees will cause them to retaliate and assign lower teaching scores to the faculty member. The finding of near-zero retaliation would be important to faculty members who evaluate trainees.

Methods: The authors used a bidirectional confidential evaluation and feedback system to test the hypothesis that faculty members who assign lower clinical performance scores to residents subsequently receive lower clinical teaching scores. From September 1, 2008, to February 15, 2013, 177 faculty members evaluated 188 anesthesia residents (n = 27,561 evaluations), and 188 anesthesia residents evaluated 204 faculty members (n = 25,058 evaluations). The authors analyzed the relationship between clinical performance scores assigned by faculty members and the clinical teaching scores received using linear regression. The authors used complete dyads between faculty members and resident pairs to conduct a mixed effects model analysis. All analyses were repeated for three different epochs, each with different administrative attributes that might influence retaliation.

Results: There was no relationship between mean clinical performance scores assigned by faculty members and mean clinical teaching scores received in any epoch (P ≥ 0.45). Using only complete dyads, the authors’ mixed effects model analysis demonstrated a very small retaliation effect in each epoch (effect sizes of 0.10, 0.06, and 0.12; P ≤ 0.01).

Conclusions: These results imply that faculty members can provide confidential evaluations and written feedback to trainees with near-zero impact on their mean teaching scores.