American Council of Academic Plastic Surgeons

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A Competency-Based Performance Feedback Tool in Plastic Surgery
Steven D. Kozusko, MD MEd, Lisa Reid, MD, Martha S. Matthews, MD FACS
Cooper University Hospital, Camden, NJ, USA

Background: There is a paucity of objective tools available in Plastic Surgery to evaluate competency-based performance of trainees. The service includes learners at multiple levels, further complicating provision of effective feedback. Time constraints are the biggest barriers to mentorship in plastic surgery. Student and rotator exposure to individual faculty members may be brief, leading to challenge in providing useful feedback, essential to achieving competence. Subjective feedback of performance is subject to bias and risks a skewed evaluation. The Liaison Committee on Medical Education requires formative assessment. Konopasak et al. introduced a formatively focused assessment system using a plan-do-study-act (PDSA) quality improvement structure. This concept was modified to create a learning plan that can be applied to single or multiple interactions for any learner. The PDSA concept is familiar to most learners, and it reinforces the understanding that mastery is dependent on continuous improvement
Methods: A formative feedback tool is introduced that has been used successfully for 3 years. After orientation, the learner is responsible to use the tool. They identify one learning goal for the session, and note the activities needed for accomplishment. After the session, they reflect on their success, identify barriers, and plan future efforts. This is shared with the supervisor and discussed. The teacher provides at least one item for formative feedback. The teacher also provides a hypothetical statement that might be used in a summative assessment, based on the day’s performance. This allows the learner to link their actions to how they may be assessed
Results: The PDSA tool can be used for a single experience; it is more robust with multiple evaluations. Mentee opinion has been positive on ease of use and utility of feedback. This tool is effective in providing meaningful feedback for a brief interaction, and can provide helpful data for summative evaluations
Conclusion: Assessment of student and rotating resident performance is challenging when interactions are limited. The PDSA tool is concise, rapid to administer, and objective when submitting feedback on medical student and rotating resident performance. It improves the quantity and quality of feedback.


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