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OBJECTIVE:To improve the quality and specificity of written evaluations by faculty attendings of internal medicine residents during inpatient rotations. DESIGN:Prospective randomized controlled trial.SETTING: Four hospitals: tertiary care university hospital, Veterans' Administration hospital, and two community hospitals.PARTICIPANTS: Eighty-eight faculty and 157 residents from categorical and primary-care internal medicine residency training programs rotating on inpatient general medicine teams. INTERVENTION:Focused 20-minute educational session on evaluation and feedback, accompanied by 3 by 5 reminder card and diary, given to faculty at the start of their attending month. MEASUREMENTS AND MAIN RESULTS:Primary outcomes: 1) number of written comments from faculty specific to unique, preselected dimensions of competence; 2) number of written comments from faculty describing a specific resident behavior or providing a recommendation; and 3) resident Likert-scale ratings of the quantity and effect of feedback received from faculty. Faculty in the intervention group provided more written comments specific to defined dimensions of competence, a median of three comments per evaluation form versus two in the control group, but when adjusted for clustering by faculty, the difference was not statistically significant (P = .09). Regarding feedback, residents in the intervention group rated the quantity significantly higher (P = .04) and were significantly more likely to make changes in clinical management of patients than residents in the control group (P = .04). CONCLUSIONS:A brief, focused educational intervention delivered to faculty prior to the start of a ward rotation appears to have a modest effect on faculty behavior for written evaluations and promoted higher quality feedback given to house staff.

PBLI and SBP can be introduced effectively in residency training by incorporating specific activities that use the metaphors of the mirror and the village.