Enhancing Professionalism in Nurse Anesthesia Education: A Randomized Controlled Trial of Multi-Source Feedback

Background: Professionalism is defined as a set of knowledge, skills, moral values, and personal and group identity that affect the quality of providing care to patients. Objectives: This study aimed to investigate the effect of Multi-Source Feedback (MSF) on the professionalism level of nurse anesthesia students. Methods: This study was a randomized controlled trial adopting a pre-test/post-test design and involved a sample of 46 third- and fourth-year nurse anesthesia students selected using the census method (27 females and 19 males with a mean age of 20.91). They were divided equally into two groups of 23 each. Students in the intervention group received MSF during the 3-month period of their academic semester. At the end of each month, they were evaluated by 3 external evaluators, including an anesthesiologist, a nurse anesthetist, and a nurse anesthesia instructor, using a researcher-made checklist. In addition to the mentioned evaluators, the students performed self-evaluation using the Professional Self-description Form (PSDF). Based on the scores of the evaluators, the necessary feedback was given to the students online and offline. Meanwhile, the students in the control group received routine training and feedback during the internship. The data were analyzed using the repeated measures MANOVA test. Results: The intervention group consistently scored higher in professionalism than the control group. Over time, the gap between the two groups increased, with the intervention group achieving significantly higher improvement (P < 0.001). In the intervention group, the mean scores obtained from all evaluators including the nurse anesthesia instructor, the nurse anesthetist, the anesthesiologist, and self-evaluation were 62.43 ± 3.86, 63.13 ± 4.67, 61.26 ± 3.94 and 80.91 ± 6.86 at baseline, which rose to 87.52 ± 6.04, 88.69 ± 6.37, 83.00 ± 7.33 and 101.82 ± 5.59, respectively (P < 0.001). Specifically, the two groups experienced an upward trend in terms of the MSF score, yet the control group displayed a slight increase, while the intervention group demonstrated a significantly steeper rise. Intergroup effect tests consistently revealed that across all evaluators, the intervention group outperformed the control group (P < 0.001). Conclusions: The multi-source evaluation process had a statistically significant effect on the level of professionalism of nurse anesthesia students. It is possible to benefit from integrating this method with other evaluation methods in future studies.