Closing the Loop in Writing: Using E-Mail to Reinforce Feedback and Enhance Communication

Residency programs sometimes struggle with documenting interactions between faculty and trainees, including educational interventions. One approach we find useful is to ask residents to summarize a conversation with a member of the faculty via a confidential e-mail. Faculty may then reply, reinforcing or expanding concepts, or clarifying misinterpretations.

Sometimes this approach is used after discussing theoretical concepts or clinical issues related to the specialty. On other occasions, it is used to address core competencies, such as those related to attitude, professionalism, and interpersonal skills.

The advantages of this strategy include prompting the learner to reflect and distill the key points of the conversation. Additionally, the correspondence reflects the level of acknowledgment and serves as documentation of the exchange.

The faculty member then has the opportunity to reply, confirming that the communication has been understood or that further elucidation is required. These correspondences can become part of the resident's educational portfolio.

If this method is used by a few members of a department, it may give the impression that those individuals requesting the written correspondence are excessively demanding. However, when used as an agreed-on mechanism, it is perceived as a matter-of-course process. Implemented constructively, we believe this is a useful approach to enhance communication while fulfilling documentation requirements.