• Effective clinical feedback provision to ambulance clinicians: a literature review

      Eaton-Williams, Peter; Mold, Freda; Magnusson, Carin (2020-03-12)
      Background Clinical feedback provision to health professionals is advocated to benefit both clinical development and work engagement. Aim This literature review aims to develop recommendations for effective clinical feedback provision by examining mechanisms that exist specifically for ambulance clinicians. Method: A systematic search of contemporary literature identified 15 research papers and four articles, which were included for review and narrative synthesis. Findings The initial identification of practice that requires improvement, together with an understanding of the practitioners' baseline attitudes, is important. While minimising resource demands will improve sustainability, repeated interaction with clinicians will benefit effectiveness. Provision should be balanced and timely, and who delivers feedback is significant. Clinical outcome feedback not restricted to specific conditions requires further consideration of which incidents will initiate feedback and what information will be supplied. Conclusion Feedback has been shown to improve clinical performance but demonstrating subsequent benefits to patient outcomes has proved more difficult. Abstract published with permission.
    • Exploring paramedic perceptions of feedback using a phenomenological approach

      Eaton-Williams, Peter; Mold, Freda; Magnusson, Carin (2020-06-01)
      Abstract published with permission. Objectives: Despite widespread advocacy of a feedback culture in healthcare, paramedics receive little feedback on their clinical performance. Provision of ‘outcome feedback’, or information concerning health-related patient outcomes following incidents that paramedics have attended, is proposed, to provide paramedics with a means of assessing and developing their diagnostic and decision-making skills. To inform the design of feedback mechanisms, this study aimed to explore the perceptions of paramedics concerning current feedback provision and to discover their attitudes towards formal provision of patient outcome feedback. Methods: Convenience sampling from a single ambulance station in the United Kingdom (UK) resulted in eight paramedics participating in semi-structured interviews. Interpretative phenomenological analysis was employed to generate descriptive and interpretative themes related to both current and potential feedback provision. Results: The perception that only exceptional incidents initiate feedback, and that often the required depth of information supplied is lacking, resulted in some participants describing an isolation of their daily practice. Barriers and limitations of the informal processes currently employed to access feedback were also highlighted. Formal provision of outcome feedback was anticipated by participants to benefit the integration and progression of the paramedic profession as a whole, in addition to facilitating the continued development and well-being of the individual clinician. Participants anticipated feedback to be delivered electronically to minimise resource demands, with delivery initiated by the individual clinician. However, a level of support or supervision may also be required to minimise the potential for harmful consequences. Conclusions: Establishing a just feedback culture within paramedic practice may reduce a perceived isolation of clinical practice, enabling both individual development and progression of the profession. Carefully designed formal outcome feedback mechanisms should be initiated and subsequently evaluated to establish resultant benefits and costs.