Use of didactic training and feedback to improve quality and acceptability of progress notes written by direct‐care staff on a psychiatric inpatient unit
Lecture plus weekly feedback turns poor progress notes into accurate ones for most psychiatric inpatient staff.
01Research in Context
What this study did
Romani et al. (2023) worked with four direct-care staff on a psychiatric inpatient unit. The team first gave a one-hour lecture on how to write clear, correct progress notes.
After the lecture, a supervisor met each staff member once a week. They looked at two notes the staff had written and gave brief, specific feedback. This continued for several weeks.
What they found
Three of the four staff jumped from shaky notes to accurate ones right after feedback started. The fourth person improved only a little.
Staff and doctors both said the training was easy to use and helped the team track patient care.
How this fits with other research
Yaw et al. (2014) ran the same recipe—lecture plus feedback—with residential staff who collect daily data. They saw the same big jump in accuracy, showing the package works across settings.
Blackman et al. (2022) tried observation and data-recording alone. Most trainees failed to hit mastery until the trainer added direct feedback, backing up Romani’s finding that lecture alone is not enough.
Johnson et al. (2024) later showed that stacking three positive statements in each feedback moment gives the biggest boost to staff accuracy. You can fold that tip into Romani’s weekly note-review routine.
Why it matters
If your team writes messy or late notes, add a five-minute feedback loop. Pick one or two notes per staff each week, mark what’s missing, and praise what’s right. Three quick positives plus one correction can lift note quality fast without extra pay or software.
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02At a glance
03Original abstract
AbstractWriting progress notes represent a critical activity of practicing clinicians in a variety of settings. They provide a way for medical practitioners, insurance companies, and others to communicate in a timely fashion regarding ongoing clinical care. Previous research showed that intervention components like didactic training, using note templates, and feedback improved the quality of progress notes. At least two questions remain despite several studies already addressing progress note writing. First, previous research most often used multiple intervention components to improve progress notes. Thus, the relative impact of two common components of interventions, such as didactic training and feedback, is unclear. Second, previous research has not evaluated the acceptability of improved progress notes for the practitioners that actually utilize them. Thus, the purpose of the current study evaluated the components of didactic training and feedback on improved progress note writing for four direct staff employed by a psychiatric inpatient unit. A second purpose of this study was to evaluate the acceptability of the training procedures by both (a) the direct‐care staff participating in this study and (b) four members of the psychiatric treatment team that used direct‐care staff progress notes to inform their clinical care. Results showed that feedback was necessary to improve the accuracy of progress notes for three of four participants. The direct‐care staff reported the training procedures as acceptable and the treatment team noted improvements in the quality of the progress notes after intervention. These data will be discussed in terms of ways to arrange effective training programs to improve direct‐care staff's progress notes.
Behavioral Interventions, 2023 · doi:10.1002/bin.1927