Feedback Redefined: Principles and Practice

Abstract

Feedback is defined as a regulatory mechanism where the effect of an action is fed back to modify and improve future action. In medical education, newer conceptualizations of feedback place the learner at the center of the feedback loop and emphasize learner engagement in the entire process. But, learners reject feedback if they doubt its credibility or it conflicts with their self-assessment. Therefore, attention has turned to sociocultural factors that influence feedback-seeking, acceptance, and incorporation into performance. Understanding and application of specific aspects of psychosocial theories could help in designing initiatives that enhance the effect of feedback on learning and growth. In the end, the quality and impact of feedback should be measured by its influence on recipient behavior change, professional growth, and quality of patient care and not the skills of the feedback provider. Our objective is to compare and contrast older and newer definitions of feedback, explore existing feedback models, and highlight principles of relevant psychosocial theories applicable to feedback initiatives. Finally, we aim to apply principles from patient safety initiatives to emphasize a safe and just culture within which feedback conversations occur so that weaknesses are as readily acknowledged and addressed as strengths.

Medical students' experiences and needs from written reflective journal feedback

“…In addition to the strong need for an emotional response, students were not satisfied with feedback that contained only encouraging, supportive and empathic components. Similar to previous studies, 43,45 students stated their wish to receive enriching and developing feedback, which encourages them to rethink their positions and beliefs and stimulates their learning (without disparaging their current understandings). We also identified the use of different types of questions that help develop reflection 1,2,5,21 .…”

“…Another explanation for this expectation may be related to the nature of the relationship between the student and the feedback provider, what others termed as ‘the educational alliance’ 99 . This includes students’ active exploration and testing of the educator's commitment to them, as individuals; students long for a relationship and a dialogue with a feedback provider 29,43 . In our medical school, these longitudinal relationships accompany and help students throughout their studies, perhaps leading to the expectation of a more informal, open relationship.…”

“…In addition to the benefits of writing in itself, feedback is also important to support learning and assist in the development of any skill, 37‐40 including reflective ability 21,29,41,42 . Feedback is defined as the information given on a task or a learning process that aims to improve future action and learning outcomes 43‐47 …”

Designing Feedback Systems: Examining a Feedback Approach to Facilitation in an Online Asynchronous Professional Development Course for High School Science Teachers

“…Much of the research on feedback loops has focused on the theoretical and practical considerations for using these loops to help attain the system's goals, especially within the disciplines of management, science, technology, engineering, and mathematics. Nevertheless, more work is needed to advance our understanding of how feedback loops can influence participant learning in online learning environments [34]. Specifically, we need to examine how feedback loops can guide the design and implementation of online feedback systems to support learners' uptake of feedback by closing feedback loops.…”

Impact of a work-based feedback intervention on student performance during clinical placements in acute-care healthcare settings: a quasi-experimental protocol for the REMARK programme

“…Current insights embrace feedback as a dialogic, 1 socio-constructivist process. [2][3][4] Accordingly, this stance shifts our lens from the mere transmission of information from expert to novice, to a shared approach between learner (ie, the person who actively engages in and even directs the feedback process) and learning partner (ie, someone who supports a learner in the feedback process) where feedback is dynamic and co-created. 5 The learner's or learning partner's control in 'driving' the feedback process changes depending on the situation, existing skills and experience and assessment requirements.…”