Perceptions of feedback up to senior doctors and nurses in a tertiary paediatric hospital: A mixed-methods study

Introduction: Feedback up from junior to senior clinical staff is important for junior staff to facilitate their workplace teaching and learning and for senior staff to develop teaching and leadership skills. The aim of our study was to explore experiences and perceptions towards feedback up in junior and senior medical and nursing staff in our tertiary paediatric hospital in Australia. Methods: We invited doctors and nurses in both junior and senior roles at our hospital to participate in a survey regarding their perceptions and experience of giving (junior staff) or receiving (senior staff) feedback up. We offered an optional interview to participants to discuss their experiences in depth. Quantitive data were analysed using descriptive statistics and qualitative data were analysed using inductive content analysis. Results: Sixty-two junior and 70 senior staff completed surveys, and six junior and six senior staff were interviewed. Although 95% of surveyed staff believed that feedback up is important, only 42% were involved in giving or receiving it. Six themes were identified in the qualitative data, including discomfort with feedback up, power dynamics, unclear expectations, no one size fits all, limited time and opportunity and tensions in feedback validity and purpose. Conclusion: Feedback up from junior to senior staff is wanted but is currently inconsistent or nonexistent in our paediatric hospital. We propose that providing an expectation, clear processes and support in engaging in feedback up would improve acceptance, ultimately leading to improved feedback literacy and a better culture of feedback.