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Make Exit Interviews Valuable for the Hospital and Graduating Residents

Julie McCoy, June 23, 2010

As the academic year draws to a close, many residency programs are conducting their final exit interviews. To be most effective, program directors and other exit interviewers must remember that these meetings are a two-way street. Not only do you provide trainees with valuable feedback, you also gain insights for program improvement.

Take advantage of uncensored feedback
Hold exit interviews in the last month of training after residents have completed all of their formal requirements, says Liana Puscas, MD, MHS, otolaryngology residency program director at Duke University School of Medicine in Durham, NC.

"You'll get unfiltered feedback about the program, didactics, faculty, and even other residents," Puscas says.

If you perform exit interviews before residents meet all of their requirements, they may withhold information, fearing retribution that could affect their graduation status.

When you meet with residents, some will be more than willing to share their opinions, whereas others may not see the value of the feedback or feel uncomfortable giving negative responses, says Eric Katz, MD, FACEP, FAAEM, emergency medicine program director at Maricopa Medical Center in Phoenix, adding that he has a strategy for drawing constructive criticism out of residents.

"I'll say, 'You spent three years of your life here. What is the one thing that you've always wanted to say but you've bitten your tongue about?' " Katz says.

That approach often succeeds, but if it doesn't work, don't push. Instead, tell residents that if they change their minds, they can call or e-mail you, Katz suggests.

Another option for getting feedback is to ask residents to complete a survey before the exit interviews, says Christine Cook, MD, OB/GYN department chair and program director at the University of Louisville in Kentucky. Cook asks common questions, such as:

  • How has the program improved since you started?
  • Which aspects have you become increasingly disappointed with since you started training?

Identify specific parts of the program you want comments on and add related questions to your questionnaire. For example, Cook emphasizes to faculty members that each trainee has strong and weak points, and it's up to them to help residents play to their strengths and work with their weaknesses. She asks residents to evaluate whether she and the faculty were successful on the survey.

Additionally, during Cook's meetings with graduating residents, she asks whether there are any junior residents who are struggling or doing exceptionally well. Residents also tend to give feedback about which attending physicians are excellent teachers, Cook says.

Impart words of wisdom
Whether you combine the exit interview with the resident's final summative evaluation or choose to hold those conversations at different times, allow residents to review any data you will discuss prior to the meeting, says Katz.

"I don't want them to sit there and read their evaluations with me," he explains. "We should talk about where they feel they are and where they're going."

During his exit conversations with residents, Katz reiterates feedback that he's given during previous conversations, but he puts a real-world spin on it.

For example, when meeting with a resident who hasn't responded well to feedback, rather than discussing an example related to the residency training, Katz will ask the resident to consider a hypothetical situation in which the peer review committee sends him or her letter regarding a patient complaint. Katz then works through the problem and possible responses with the resident.

Don't be hesitant to broach personal topics with graduating residents. Help them set personal and professional goals, Cook says.


Julie McCoy is an associate editor for the residency department at HCPro, Inc. Read more residency news at www.residencymanager.com.

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