Letters to the Editor
To the Editor:
We welcome your review by Reinders1 highlighting the limited data supporting the effectiveness of patient feedback on improving physicians’ consultation skills. To address this, we seek to highlight the potential role of registry data from medical licensing authorities using patient feedback as a mandatory requirement for physician training and revalidation.2 This process has the potential to further research the reliability, validity, and delivery of patient feedback tools.
We acknowledge the author’s recognition that feedback is an essential part of medical education as supported by the wider literature.3 We propose the research agenda should focus on not if, but how to implement patient feedback. In the United Kingdom, doctors’ performance data are collected in a national registry for the purposes of continued medical licensing and revalidation. This registry includes standardized patient feedback questionnaires in addition to other sources of physician performance such as workplace-based assessments and significant event analysis. Analysis of a large cohort of patient feedback data in this setting may identify previously unidentified predictors of future observed or actual performance. For example, problems communicating risk identified from patient feedback may correlate with a particular adverse clinical event. These data could then support early intervention by supervising physicians to address problems in a format that is likely to have improved face validity for trainees. This process can then form the basis for the iterative development and quality improvement of patient feedback mechanisms.
To conclude, feedback is an essential component of improving continuing medical education, and patient perceptions should be no exception. We propose that further research should use national licensing registries with the ability to triangulate other measurements of physicians’ performance.
Christian H. Hariman, MBChB, MRCP
Clinical teaching fellow, University Hospital Coventry & Warwickshire, Coventry, United Kingdom;
James Bateman, MBChB, MRCP, PGA MedEd
Arthritis Research UK education research fellow, Warwick University, Warwick, United Kingdom.
Jack Bond, BMBS, MRCP
Clinical teaching fellow, University Hospital Coventry & Warwickshire, Coventry, United Kingdom.
1. Reinders ME, Ryan BL, Blankenstein AH, van der Horst HE, Stewart MA, van Marwijk HW. The effect of patient feedback on physicians’ consultation skills: A systematic review. Acad Med. 2011;86:1426–1436
2. General Medical Council.. Revalidation: A Statement of Intent. 2010 London, UK General Medical Council
3. Veloski J, Boex JR, Grasberger MJ, Evans A, Wolfson DB. Systematic review of the literature on assessment, feedback and physicians’ clinical performance*: BEME Guide No. 7. Med Teach. 2006;28:117–128