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106 The types and effects of feedback received by emergency ambulance staff: A systematic mixed studies review with narrative synthesis
  1. Caitlin Wilson1,
  2. Jonathan Benn1,
  3. Gillian Janes2,
  4. Rebecca Lawton3
  1. 1University of Leeds
  2. 2Manchester Metropolitan University
  3. 3University of Leeds/Bradford Institute for Health Research


Aims/Objectives/Background The phenomenon of feedback is well-researched within the wider healthcare context, where it is suggested that feedback can improve patient care and patient safety by enhancing clinical performance and staff mental health. Within prehospital care, reviews have been conducted for automated feedback from defibrillators and debrief after simulation, but not on the wider concept of feedback. The aim of this systematic review is to identify, describe and synthesize the published literature on the types and effects of feedback received by emergency ambulance staff. PROSPERO CRD42020162600.

Methods/Design The search strategy consisted of three facets: ambulance staff synonyms, feedback synonyms and feedback content. Databases searched from inception were MEDLINE, EMBASE, AMED, PsycInfo, HMIC, CINAHL and Web of Science. Studies were included if they were qualitative or quantitative empirical research exploring the concept of feedback, i.e. the systematised provision of information to emergency ambulance staff regarding their performance within prehospital practice. Study quality was appraised using the Mixed Methods Appraisal Tool and data analysed using narrative synthesis.

Results/Conclusions The search strategy yielded 2424 articles excluding duplicates. 94 studies met the inclusion criteria after full-text review, of which 36 fleetingly mentioned increased feedback as a solution to improving specific circumstances (e.g. decision-making, burnout). The remaining 58 studies consisted of 48 interventional prehospital feedback studies, 8 non-interventional studies and 2 feasibility studies. Narrative synthesis revealed a wide range of prehospital feedback types with the majority of studies focusing on performance or patient outcome feedback. The effects of feedback encompassed both personal and professional development, such as improved decision-making, reflection and closure. Mechanisms of providing prehospital feedback varied from electronic dashboards to case reviews and performance appraisals. Further empirical research is required to explore whether the published literature reflects current prehospital practice, as well as to determine the when, what, how and why of ambulance staff desiring feedback.

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