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Abstract BackgroundHealth care professionals must learn continuously as a core part of their work. As the rate of knowledge production in biomedicine increases, better support for health care professionals’ continuous learning is needed. In health systems, feedback is pervasive and is widely considered to be essential for learning that drives improvement. Clinical quality dashboards are one widely deployed approach to delivering feedback, but engagement with these systems is commonly low, reflecting a limited understanding of how to improve the effectiveness of feedback about health care. When coaches and facilitators deliver feedback for improving performance, they aim to be responsive to the recipient’s motivations, information needs, and preferences. However, such functionality is largely missing from dashboards and feedback reports. Precision feedback is the delivery of high-value, motivating performance information that is prioritized based on its motivational potential for a specific recipient, including their needs and preferences. Anesthesia care offers a clinical domain with high-quality performance data and an abundance of evidence-based quality metrics. ObjectiveThe objective of this study is to explore anesthesia provider preferences for precision feedback. MethodsWe developed a test set of precision feedback messages with balanced characteristics across 4 performance scenarios. We created an experimental design to expose participants to contrasting message versions. We recruited anesthesia providers and elicited their preferences through analysis of the content of preferred messages. Participants additionally rated their perceived benefit of preferred messages to clinical practice on a 5-point Likert scale. ResultsWe elicited preferences and feedback message benefit ratings from 35 participants. Preferences were diverse across participants but largely consistent within participants. Participants’ preferences were consistent for message temporality (α=.85) and display format (α=.80). Ratings of participants’ perceived benefit to clinical practice of preferred messages were high (mean rating 4.27, SD 0.77). ConclusionsHealth care professionals exhibited diverse yet internally consistent preferences for precision feedback across a set of performance scenarios, while also giving messages high ratings of perceived benefit. A “one-size-fits-most approach” to performance feedback delivery would not appear to satisfy these preferences. Precision feedback systems may hold potential to improve support for health care professionals’ continuous learning by accommodating feedback preferences.

Background: To assess the impact of the lung cancer screening protocol recommended by the European Society of Thoracic Imaging (ESTI) on nodule diameter, volume, and density throughout different computed tomography (CT) scanners. Methods: An anthropomorphic chest phantom containing fourteen different-sized (range 3–12 mm) and CT-attenuated (100 HU, −630 HU and −800 HU, termed as solid, GG1 and GG2) pulmonary nodules was imaged on five CT scanners with institute-specific standard protocols (PS) and the lung cancer screening protocol recommended by ESTI (ESTI protocol, PE). Images were reconstructed with filtered back projection (FBP) and iterative reconstruction (REC). Image noise, nodule density and size (diameter/volume) were measured. Absolute percentage errors (APEs) of measurements were calculated. Results: Using PE, dosage variance between different scanners tended to decrease compared to PS, and the mean differences were statistically insignificant (p = 0.48). PS and PE(REC) showed significantly less image noise than PE(FBP) (p < 0.001). The smallest size measurement errors were noted with volumetric measurements in PE(REC) and highest with diametric measurements in PE(FBP). Volume performed better than diameter measurements in solid and GG1 nodules (p < 0.001). However, in GG2 nodules, this could not be observed (p = 0.20). Regarding nodule density, REC values were more consistent throughout different scanners and protocols. Conclusion: Considering radiation dose, image noise, nodule size, and density measurements, we fully endorse the ESTI screening protocol including the use of REC. For size measurements, volume should be preferred over diameter.