When general surgery residents receive regular, one-on-one feedback about preventing blood clots in patients, it works better than when they sit in group lectures, according to a study in Annals of Surgery.
The study involved 49 general surgery residents at The Johns Hopkins Hospital in Baltimore. For the first three months of the study, the residents, who were in their first through fifth year of training, received no personalized feedback on their individual performance with blood clot prevention. In the next three months, they received personal scorecards via email, which included details on how many times they prescribed the appropriate treatment and how they compared to their peers. Then, in the following three months, residents continued to receive their scorecards and under-performers received one-on-one coaching from a senior resident.
In the six months with the intervention, the hospital saw a decrease in the number of preventable complications among surgery patients: In the first three months of the study, three surgery patients developed complications that could have been prevented, and no such preventable harm complications occurred in the subsequent six months.
Additionally, the number of patients receiving the proper treatment for blood clots increased from 89 percent to 96 percent.
"Our results show personalized, concrete feedback can be a form of forced introspection that improves self-awareness and decision-making on clotting prophylaxis," said Elliott Haut, MD, PhD, a senior author on the study and an associate professor of surgery, anesthesiology and critical care medicine.
The study's findings could be applied to more practices than just blood clots, according to experts. "If our findings are borne out by larger studies, this approach could be harnessed to improve training and outcomes for anyone who touches a patient, from nurses to physicians to physical therapists," said Dr. Haut.