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Original Research
Evaluating postgraduate family medicine supervisor feedback in registrars’ learning portfolios
Submitted: 12 July 2022 | Published: 20 December 2022
About the author(s)
Neetha J. Erumeda, Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Gauteng Department of Health, Ekurhuleni District Health Services, Germiston, South AfricaAnn Z. George, Centre of Health Science Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Louis S. Jenkins, Division of Family Medicine and Primary Care, Department of Family and Emergency Medicine, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; and, George Hospital, Western Cape Department of Health, George, South Africa; and, Primary Health Care Directorate, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Abstract
Background: Postgraduate supervision forms a vital component of decentralised family medicine training. While the components of effective supervisory feedback have been explored in high-income countries, how this construct is delivered in resource-constrained low- to middle-income countries has not been investigated adequately.
Aim: This article evaluated supervisory feedback in family medicine registrars’ learning portfolios (LPs) as captured in their learning plans and mini-Clinical Evaluation Exercise (mini-CEX) forms and whether the training district or the year of training affected the nature of the feedback.
Setting: Registrars’ LPs from 2020 across five decentralised sites affiliated with the University of the Witwatersrand in South Africa were analysed.
Methods: Two modified tools were used to evaluate the quantity of the written feedback in 38 learning plans and 57 mini-CEX forms. Descriptive statistics, Fisher’s exact and Wilcoxon rank-sum tests were used for analysis. Content analysis was used to derive counts of areas of feedback.
Results: Most learning plans (61.2%) did not refer to registrars’ clinical knowledge or offer an improvement strategy (86.1%). The ‘extent of supervisors’ feedback’ was rated as ‘poor’ (63.2%), with only 14.0% rated as ‘good.’ The ‘some’ and ‘no’ feedback categories in the mini-CEX competencies (p < 0.001 to p = 0.014) and the ‘extent of supervisors’ feedback’ (p < 0.001) were significantly associated with training district. Feedback focused less on clinical reasoning and negotiation skills.
Conclusion: Supervisors should provide specific and constructive narrative feedback and an action plan to improve registrars’ future performance.
Contribution: Supervisory feedback in postgraduate family medicine training needs overall improvement to develop skilled family physicians.
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