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Canadian Journal of Gastroenterology and Hepatology
Volume 2016, Article ID 4983790, 6 pages
Research Article

How to Make Feedback More Effective? Qualitative Findings from Pilot Testing of an Audit and Feedback Report for Endoscopists

1Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
2Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
3Sunnybrook Health Sciences Centre, Toronto, ON, Canada
4Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
5Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
6Department of Surgery and Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
7Department of Medicine, University of Toronto, Toronto, ON, Canada
8Cancer Care Ontario, Toronto, ON, Canada

Received 11 February 2016; Accepted 21 August 2016

Academic Editor: Jennifer Jones

Copyright © 2016 Fiona Webster et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Audit and feedback (A/F) reports are one of the few knowledge translation activities that can effect change in physician behavior. In this study, we pilot-tested an endoscopist A/F report to elicit opinions about the proposed report’s usability, acceptability and usefulness, and implications for knowledge translation. Methods. Semi-structured qualitative interviews were conducted with eleven endoscopists in Ontario, Canada. We tested an A/F report template comprising 9 validated, accepted colonoscopy quality indicators populated with simulated data. Interview transcripts were coded using techniques such as constant comparison and themes were identified inductively over several team meetings. Results. Four interrelated themes were identified: (1) overall perceptions of the A/F report; (2) accountability and consequences for poor performance; (3) motivation to change/improve skills; and (4) training for performance enhancement and available resources. The A/F report was well received; however, participants cited some possible threats to the report’s effectiveness including the perceived threat of loss of privileges or licensing and the potential for the data to be dismissed. Conclusions. Participants agreed that A/F has the potential to improve colonoscopy performance. However, in order to be effective in changing physician behavior, A/F must be thoughtfully implemented with attention to the potential concerns of its recipients.