Fig 1.
Themes with selected quotes from internal medicine resident (IMR) and hospitalists on their concerns about verbal feedback being observed by a faculty feedback observer.
Fig 2.
Selected quotes from internal medicine resident (IMR) and hospitalists on strategies that would mitigate concerns about verbal feedback being observed by a faculty feedback observer.
Fig 3.
A proposed model for factors that impact the psychological safety of teacher and learners in the setting of directly observed feedback delivery.
In this model, these factors impact teacher and learner independently and influence the degree of psychological safety. The degree of psychological safety sets the stage for a feedback observation. If there is insufficient psychological safety, it is unlikely that a feedback observation will be a productive tool for improvement and may be detrimental to either the learner or teacher. If there is a high degree of psychological safety, the feedback observation can likely occur and there will be minimal impact on the feedback content as a result of the observation. If the psychological safety is somewhere in the middle, a feedback observation may occur, but the feedback content may be more heavily influenced by the observation.