The Effect of Anonymity on Quality of Resident Feedback

Abstract

Objective: Quality feedback is critical to facilitate better performance and quicker learning. However, faculty may be hesitant to provide quality constructive feedback, especially in written form, due to fear of retaliation. We evaluated the impact of faculty anonymity on the quality of faculty-to-resident feedback.

Design: A retrospective review was undertaken of faculty evaluation of resident performance from 2017 to 2018, when evaluations were identifiable, compared to 2018-2019, when evaluations were anonymous. Evaluations included 27 individual items with Likert type scoring and 2 open-ended questions. Open-ended responses and overall performance were de-identified and scored by 2 reviewers independently using the task, performance gap, action scoring model. Comparisons between groups were performed with the Wilcoxon-Mann-Whitney test.

Setting: Tertiary Care Institution, University of Michigan, Ann Arbor, MI PARTICIPANTS: 415 resident performance evaluations were available for analysis with 251 in the identifiable group and 164 in the anonymous group.

Results: The average composite score for the identifiable group was 105.2 and 103.4 in the anonymous group (p = 0.22). The effect size of the impact on composite score was small (Cohen's d 0.084, 95% CI -0.11-0.28). There was excellent inter-rater reliability. There were no differences between feedback groups for any of the 3 components of task, performance gap, and action model. While average scores for all 3 components were low, action scores were lowest.

Conclusions: Anonymity did not significantly impact faculty evaluations of resident performance. The quality of open-ended feedback on written evaluations was generally poor, especially in identifying actions for continued performance improvement. Additional mechanisms to improve feedback quality should be sought.

Keywords: Anonymity; Feedback; Medical Education; Resident.