Feedback Quality of Thai Emergency Workplace-based Assessments After implementing mobile application

Purpose Feedback is essential to learning. However, there are barriers to giving and receiving high-quality feedback in the clinical workplace. This national study explores changes to feedback quality and its associated factors in workplace-based assessments, following the implementation of innovative mobile applications. Method This is a multi-center, prospective cohort study (n = 492 participants: 135 faculty and 357 residents). Data were collected during July 2019 - March 2020. A mobile application was developed that included notification, guide for feedback for faculty, guide for self-reflection for residents, and Entrustable Professional Activity (EPA) dashboard features. Feedback quality was measured across five domains: 1. Timeliness; 2. Respect and communication; 3. Specific; 4. Action Plan; and 5. Feedback culture at baseline, 3,6, and 9 months after implementing those features in order step by step. Domain-level scores were calculated as the percentage of maximum achievable score (POMS). Linear mixed models were used to estimate longitudinal changes in feedback quality. Results Quality of faculty feedback improved significantly in all five dimensions (timeliness, communication, specificity, action plan, culture) over 6 to 9 months. The overall adjusted mean changes at 9-month period increased to 2.88 units from baseline (95% CI: 0.83 - 4.93; standardized β = .20), P-value = 0.006. Factors associated with improved quality included frequency of mobile-application use, review of dashboard prior to feedback, and prior feedback strategy at the institutional level. Conclusions Implementing technology-enhanced mobile application nationwide, which includes real-time notification, guide for feedback quality, and dashboard features can improve faculty feedback quality in the workplace within nine months. Using an application every week, reviewing learner dashboard, and developing institutional strategies can further improve feedback quality using workplace-based assessments.