Darren Nichols

Background Narrative feedback, like verbal feedback, is essential to learning. Regardless of form, all feedback should be of high quality. This is becoming even more important as programs incorporate narrative feedback into the constellation of evidence used for summative decision-making. Continuously improving the quality of narrative feedback requires tools for evaluating it, and time to score. A tool is needed that does not require clinical educator expertise so scoring can be delegated to others. Objective To develop an evidence-based tool to evaluate the quality of documented feedback that could be reliably used by clinical educators and non-experts. Methods Following a literature review to identify elements of high-quality feedback, an expert consensus panel developed the scoring tool. Messick's unified concept of construct validity guided the collection of validity evidence throughout development and piloting (2013–2020). Results The Evaluation of Feedback Captured Tool (EFeCT) contains 5 categories considered to be essential elements of high-quality feedback. Preliminary validity evidence supports content, substantive, and consequential validity facets. Generalizability evidence supports that EFeCT scores assigned to feedback samples show consistent interrater reliability scores between raters across 5 sessions, regardless of level of medical education or clinical expertise (Session 1: n=3, ICC=0.94; Session 2: n=6, ICC=0.90; Session 3: n=5, ICC=0.91; Session 4: n=6, ICC=0.89; Session 5: n=6, ICC=0.92). Conclusions There is preliminary validity evidence for the EFeCT as a useful tool for scoring the quality of documented feedback captured on assessment forms. Generalizability evidence indicated comparable EFeCT scores by raters regardless of level of expertise.