From Disengagement to Leniency: Overcoming Barriers to Giving Critical Feedback in Emergency Medicine
by McKenna Knych, M.D. | October 15, 2024
Article Citation: Laurin S, Castonguay V, Dory V, Cusson L, Côté L. “They were very, very nice but just not very good”: The Interplay Between Resident-Supervisor Relationships and Assessment in the Emergency Setting. AEM Educ Train 2024; 8(2):e10976. DOI: 10.1002/aet2.10976
What is this article about?
This article explores the dynamics between residents and supervisors in emergency settings, highlighting the complexity of these relationships and how they influence the assessment process. The study reports the findings from semi-structured interviews of 15 clinical supervisors in emergency medicine. Thematic analysis revealed that almost all types of resident-supervisor relationships can hinder supervisors’ willingness to give negative feedback. For instance, weak relationships lead to supervisor disengagement and lowering of expectations. Negative relationships might cause supervisors to hesitate to reveal resident weaknesses due to their awareness of personal bias or fear of a negative reaction from the resident. Positive relationships can lead supervisors to give more lenient feedback. The study found that supervisors who were able to provide negative feedback held the belief that disclosing resident weaknesses was part of their educational responsibility.
Why should you read the article?
Providing honest feedback and identifying areas for improvement are crucial parts of education and key responsibilities of supervisors toward learners. Yet, despite educators’ best intentions, the “failure to fail” is a well-documented phenomenon in health professions education. This article adds to the literature by looking specifically at the impact of different types of resident-supervisor relationships on supervisors’ reluctance to disclose residents’ weaknesses. It explores this in the unique context of emergency medicine, where the resident-supervisor relationship develops in an acute care setting through a series of sporadic interactions over a given time.
How can you use this article?
By identifying and understanding how different trainee-supervisor relationships can hinder the delivery of negative feedback, strategies to help supervisors build a constructive educational alliance with residents or students can be developed. As a result, more accurate assessments of residents and medical students will foster their learning. This article encourages critical evaluation of one’s own relationships with trainees, highlighting the benefits, rather than harms, of honesty and discussing areas of weakness. The authors emphasize how addressing these weaknesses is challenging – but essential – to helping trainees achieve their developmental and professional goals.
Review Author: McKenna Knych, M.D., Assistant Professor of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI. Organization: Clerkship Directors in Emergency Medicine