The Effects of Feedback Fatigue and Sex Disparities in Medical Student Feedback Assessed Using a Minute Feedback System.

OBJECTIVE: Feedback is critical to the development of medical students. To enhance feedback, we created a web application, the Minute Feedback System (MFS). This app allows students to request precise, timely, written feedback from residents and staff without the burden of vague, end-of-rotation surveys. In this study, we investigate variations in response rates and feedback fatigue based on sex and rank (resident/fellow vs. faculty).

DESIGN: Data were collected from May 2015-October 2016. The MFS stores student requests for feedback along with faculty responses allowing for analysis of feedback response rate as well as sex and rank identification. Variation in response rate was analyzed using Chi-square and log-rank testing. Feedback fatigue was assessed using Cox regression modeling.

SETTING: University Affiliated, Tertiary Care Center.

PARTICIPANTS: Medical Students, Residents and Faculty.

RESULTS: About 98.6% of students (138 women, 140 men) used the MFS on their surgery clerkship. They requested feedback from 159 trainees (residents or fellows) and 114 surgical faculty. Feedback was requested more from faculty (26.3 requests per individual) compared to trainees (16.4 requests per individual). The overall evaluator response rate was 60%. Male students were 13% less likely to receive feedback than female students. There was a higher prevalence of feedback fatigue among female faculty (11% less likely to respond) and residents (23% less likely to respond). Regression analysis showed that the overall hazard of nonresponse over time was 1.05, indicative of overall feedback fatigue among all respondents.

CONCLUSIONS: The MFS is a novel tool for feedback used by nearly all M3 students during their surgery clerkship at our institution. Evaluation of response rates demonstrated feedback fatigue, especially among women faculty and residents. Feedback fatigue was more likely to affect male students, although the reason for this is unclear. Further analysis is necessary to understand this sex-associated response disparity and its effect on student feedback in the learning environment.