**3. Results**

#### **3.1 Participants**

Between January 2017 and May 2017, 20 patients (n = 20) from OLVG hospital participated in this study. The participants were between the age of 21 and 74 years old, recruited from 12 different departments (**Table 2**) and half of them were female. The interviews lasted between 10 and 40 minutes. Four patients refused to participate due to lack of time or interest. A total of 15 residents, recruited from eight different departments, filled in the questionnaire (**Table 2**).

Below, the findings will be presented in two sections; patients' perspective and a residents' perspective, after which the two will be compared.

#### **3.2 Patients' perspective**

Generally speaking, all patients were able to put forward several topics for providing feedback to residents. However, it became apparent that patients who had mainly positive experiences with residents or other physicians had more difficulties providing topics compared to patients with rather negative experiences. Patients did not mention topics they prefer not to provide feedback on.


#### **Table 2.**

*Departments patients and residents were involved.*

#### *3.2.1 Involvement in medical decision making*

Patients expressed that they wish to provide feedback on how a resident involves them in the process of medical decision making during which the resident gives them advice on the best options for treatments. They reported that they find it important that the final decision is up to them. This topic was explicitly mentioned because patients currently experience little room for shared medical decision-making.

"*The specialists must have all the knowledge to communicate what is best for the patient. And the patient, I think, must listen very carefully to what is being said. And weigh up the advice. […] So yes, it is up to the patient I think to decide what he [or she] wants to do.*" (Male, cardiology department, interview 3).

#### *3.2.2 Organizational matters*

Patients mentioned waiting time as feedback residents can learn from. They have the feeling that the schedule is too tight. Ideally, patients also wish to provide feedback on making appointments and the hospital experience in general.

*"Well, I think there are a few key points which should be dealt with such as simple things like waiting time. Isn't the planning too tight? […]there was a sign which said that the waiting time was approximately one hour, one and a half hours."* (Male, pulmonary medicine department, interview 2).

#### *3.2.3 Personal aspects*

Additionally, patients wish to provide feedback on personal aspects such as a resident's representativeness, including a resident's personal hygiene. Furthermore, patients also mentioned their general attitude as well as their tone of voice and kindness.

"*No, not the appearance, but grooming. Yes, you could say something about that. Yes. It is very disturbing if a physician sweats a lot or smells, that's just unpleasant. You could say something about that*." (Male, orthopedics department, interview 14).

#### *3.2.4 Communication of medical knowledge*

Patients also desire to provide feedback on a resident's ability to explain a diagnosis. The resident should be able to do this in understandable words and avoid medical jargon as much as possible. Patients also described transparency about medical uncertainties and guidance through the medical process as important topics for feedback. Patients would like to understand their medical condition and take its uncertainties into account when deciding on treatment options. However, residents do not need to explain everything in detail but should pay close attention to the information that concerns the patients and be honest about it. Furthermore, they find it important that physicians guide them and explain every action step by step in order for them to know what to expect.

*"They couldn't find anything on the MRI scan and they didn't explain further. I was overwhelmed by this. […] I still had a lot of pain. […] I don't think that's providing an explanation. […] it is my body and I feel the pain."* (Male, orthopedic department, interview 15).

*Patient Feedback to Enhance Residents' Learning: A Patient and a Resident Perspective DOI: http://dx.doi.org/10.5772/intechopen.108569*

#### *3.2.5 The physician-patient relationship*

Lastly, patients wish to provide feedback on the continuity of care. This involves topics such as seeing the same physician every visit and communication between physicians because it clearly influences the physician-patient relationship. Patients stated that residents should be aware of a patient's personal situation and take this into account when providing medical advice. In order to do that, residents should communicate well with each other in order to prevent patients to have to repeatedly explain their stories. Furthermore, patients find it important to provide feedback on how residents approach their patients, for example, whether a resident listens to them, takes them seriously, takes time during the consultation, and shows a real interest. In addition, patients preferred that a physician sees them as a human and not as a disease or a problem to be solved.

"*It is very alienating when a physician looks at you as if you are a problem. As if you are not really there. As if the soul or the self in the body is not of interest anymore. But you are dealing with living creatures. […] It is a human who has a problem and not a thing that's broken. I find that important*." (Male, orthopedics department, interview 14).
