Strengths and limitations
UTI
One strength for this study is that feedback was given by a peer which has been shown to have positive effects as opposed to if feedback is given by a senior or a supervisor. Another strength of the study was the contribution to the current approach to management of suspected UTI by medical officers and the identification of issues that can be targeted in further interventions. The study was limited by a small number of physicians, meaning that small effects may have been missed and would have affected the generalizability of the results and its applications to a larger setting. However, it is unlikely major improvements were missed, especially in view of the small improvements in individual components such as the use of nitrofurantoin. Secondly, the small patient volumes experienced due to the COVID 19 pandemic limited the number of available charts for review. Thirdly, we may have delivered an insufficient dose (a single feedback session) of the intervention to effect practice change. 