Factors influencing trainers' feedback-giving behavior: a cross-sectional survey.

BACKGROUND: The literature provides some insight into the role of feedback givers, but little information about within-trainer factors influencing 'feedback-giving behaviours'. We looked for relationships between characteristics of feedback givers (self-efficacy, task perception, neuroticism, extraversion, agreeableness and conscientiousness) and elements of observation and feedback (frequency, quality of content and consequential impact). METHODS: We developed and tested several hypotheses regarding the characteristics and elements in a cross-sectional digital survey among GP trainers and their trainees in 2011 and 2012. We conducted bivariate analysis using Pearson correlations and performed multiple regression analysis. RESULTS: Sixty-two trainer-trainee couples from three Dutch institutions for postgraduate GP training participated in the study. Trainer scores on 'task perception' and on a scale of the trait 'neuroticism' correlated positively with frequency of feedback and quality of feedback content. Multiple regression analysis supported positive correlations between task perception and frequency of feedback and between neuroticism and quality of feedback content. No other correlations were found. CONCLUSION: This study contributes to the literature on feedback giving by revealing factors that influence feedback-giving behaviour, namely neuroticism and task perception. Trainers whose task perception included facilitation of observation and feedback (task perception) and trainers who were concerned about the safety of their patients during consultations with trainees (neuroticism) engaged more frequently in observation and feedback and gave feedback of higher quality.

Patient complaints in general practice seen through the lens of professionalism: a retrospective observational study.

BACKGROUND: Professionalism is a key competence for physicians. Patient complaints provide a unique insight into patient expectations regarding professionalism. Research exploring the exact nature of patient complaints in general practice, especially focused on professionalism, is limited. AIM: To characterise patient complaints in primary care and to explore in more detail which issues with professionalism exist. DESIGN & SETTING: A retrospective observational study in which all unsolicited patient complaints to a representative out-of-hours general practice (OOH GP) service provider in The Netherlands were analysed over a 10-year period (2009-2019). METHOD: Complaints were coded for general characteristics and thematically categorised using the CanMEDS Physician Competency Framework (CanMEDS) as sensitising concepts. Complaints categorised as professionalism were subdivided using open coding. RESULTS: Out of 746 996 patient consultations (telephone, face-to-face, and home visits) 484 (0.065%) resulted in eligible complaint letters. The majority consisted of two or more complaints, resulting in 833 different complaints. Most complaints concerned GPs (80%); a minority (19%) assistants. Thirty-five per cent concerned perceived professionalism lapses of physicians. A rich diversity in the wording of professionalism lapses was found, where ' not being taken seriously ' was mentioned most often. Forty-five per cent related to medical expertise, such as missed diagnoses or unsuccessful clinical treatment. Nineteen per cent related to management problems, especially waiting times and access to care. Communication issues were only explicitly mentioned in 1% of the complaints. CONCLUSION: Most unsolicited patient complaints were related to clinical problems. A third, however, concerned professionalism issues. Not being taken seriously was the most frequent mentioned theme within the professionalism category.