Impact of Faculty and Resident Education on the Quality of Narrative Feedback in Residency: An Interventional Study

Abstract

In 2022, a university-affiliated internal medicine residency program implemented targeted educational interventions about feedback for both faculty and residents. Faculty members participated in biannual 90-min interactive workshops on core principles of high-quality feedback, common barriers to implementation, and delivery of action-oriented feedback. Residents attended a 60-min workshop focused on deliberate practice, goal creation, and building expertise through feedback. To assess the impact of these educational interventions, narrative assessments and written feedback from faculty to residents, were collected from resident feedback forms for the academic years 2021–2022 (pre-intervention period) and 2022–2024 (post-intervention period). The assessments were de-identified and evaluated by two independent scorers using the Narrative Evaluation Quality Instrument (NEQI), which quantitatively scores feedback on three categories: “performance domains commented on,” “specificity of comments,” and “usefulness to the trainee.” Each assessment received a total score ranging from 0 to 12, with higher scores indicating higher quality feedback. A total of 1206 narrative assessments met the inclusion criteria, with 316 in the pre-intervention period and 890 in the post-intervention period. The mean NEQI score increased from 2.48 before the intervention to 3.37 after the intervention, indicating a statistically significant improvement ( P < 0.001). The effect size was 0.5, and the intraclass correlation coefficient (ICC) was 0.92 (Table 1 ).