Hierarchy, “Kreng Jai” and Feedback: A Grounded Theory Study Exploring Perspectives of Clinical Faculty and Medical Students in Thailand

Areemit, Rosawan; Cooper, Cynthia; Wirasorn, Kosin; Paopongsawan, Pongsatorn; Panthongviriyakul, Charnchai; Ramani, Subha

doi:10.1080/10401334.2020.1813584

Cited by 12 publications

(20 citation statements)

References 50 publications

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“…In this study, both the teachers and students considered reinforcing positive performances as an essential component of feedback, as it encourages students and helps them maintain good practices. Participants in this study perceived a lack of balance between reinforcement and correction in the local context, a phenomenon noted by educators in the region [ 38 ] and identified in other studies [ 6 , 35 ]. The present study identified possible reasons behind this limited reinforcement.…”

Section: Discussionmentioning

confidence: 89%

“…Most students have learned to overlook the harsh elements and focus on the learning points. Similar to this study, students in East Asian cultures believed that although harsh feedback made them uncomfortable, it could be useful when they perceived the teacher’s intent to be improving their performance and acting in their best interest [ 6 ]. Suhoyu et al [ 41 ] also found that students in Asian cultures believed corrections were more valuable than reinforcements.…”

Section: Discussionmentioning

confidence: 90%

“…Feedback was seen by the participants as information provided by the teacher rather than a discussion between the teacher and students. Another study in the Southeast Asian region which has similar cultural context also found that the teachers expressed that it was their responsibility to provide feedback to students under their supervision [ 6 ]. Our study identified the possible reasons for this in the local context as feedback focused on correction of errors, the prevalent hierarchical culture, lack of visibility of other learners such as residents seeking feedback and a lack of training in feedback.…”

Section: Discussionmentioning

confidence: 99%

“…In this study the participants perceived that error correction was the primary function of feedback. Similar to other studies in East Asian cultures [ 6 , 40 ], feedback was initiated when teachers identified deficits and provided corrections to the students. Feedback was often provided in a direct and sometimes harsh manner, with perceived advantages in terms of students gaining a clear understanding of their errors and the necessary corrections.…”

Section: Discussionmentioning

confidence: 99%

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Feedback practices in undergraduate clinical teaching in Sri Lanka - a qualitative study

Sanchayan,

Olupeliyawa,

Chandratilake

2024

BMC Med Educ

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Background Feedback is integral to medical education, enabling students to improve their knowledge, skills, and attitudes. Feedback practices may vary according to prevalent cultural and contextual factors. This study aimed to explore how feedback is conceptualized and practised in the clinical education of medical students in Sri Lanka. Methods The study was conducted in three medical schools and affiliated hospitals that represent the cultural diversity of Sri Lanka. Purposive sampling was utilized to recruit clinical teachers and students who would provide rich information for the study. The study had three components: an observation study, interviews with clinical teachers and focus group discussions with clinical students. During the observation study, video recording was used as a data collection tool to observe feedback in real-life clinical teaching/learning settings. A constructivist grounded theory approach was adapted for analysis to explore current practices and perceptions inductively. Results Feedback was conceptualised as spontaneous unidirectional provision of information for the improvement of students. It was often provided in public settings and in student groups. Error correction was the primary focus of feedback, but both teachers and students desired a balanced approach with reinforcement and reflection. Although the direct approach to corrective feedback was found beneficial for student learning, participants agreed that harsh feedback was to be avoided. The hierarchical culture and lack of programmed feedback in the curricula influenced feedback practices, suggesting the need for modification. Conclusions This study highlighted feedback practices in the local context, emphasizing the need to address the hierarchical gap in clinical settings, balance reinforcement and correction, and promote dialogue and reflection in the feedback processes. The findings will help clinical teachers from both the global south as well as the global north to recognize cultural and contextual differences in providing feedback.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Feedback practices in undergraduate clinical teaching in Sri Lanka - a qualitative study

Sanchayan,

Olupeliyawa,

Chandratilake

2024

BMC Med Educ

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“… 2 Anade is a concept inherent to understanding Myanmar’s culture and social relationships, indicating politeness and the value of not putting a burden on someone by sharing ones worries or by initiating care provision by other people. Although there is no direct translation to English, it is a concept comparable to “Kreng Jai” in neighboring Thailand, which has been covered more widely in research (e.g., Areemit et al, 2021 ). …”

mentioning

confidence: 99%

Loneliness in Myanmar’s older population: A mixed-methods investigation

Akhter-Khan

Wai²,

Drewelies

2022

J Cross Cult Gerontol

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Objectives Little is known about loneliness in lower- and middle-income countries. This study investigates loneliness in the older population of Myanmar using a mixed-methods approach. Methods To identify predictors of loneliness, hierarchical regression models were used to analyze data from the Myanmar Aging Survey 2012 (N = 3,618, 57% women). In a mixed-methods sequential explanatory design, quantitative data were integrated with qualitative data from semi-structured interviews with older adults in Myanmar in 2019. Results The prevalence of loneliness varied by between-person characteristics. Health impairments, lower income, being widowed, not having children, and living with fewer household members were each associated with loneliness. Qualitative findings suggested that the physical presence of family members was especially protective against loneliness. Religion had mixed associations with loneliness, depending on the type of religious practice, demographic characteristics, health status, and community engagement. Discussion The findings contribute to a better understanding of individuals’ experiences of loneliness and may inform the design of interventions to prevent loneliness in Myanmar and globally.

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Factors affecting perceived credibility of assessment in medical education: A scoping review

Long

Rodríguez

St‐Onge

et al. 2021

Adv in Health Sci Educ

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Hierarchy, “Kreng Jai” and Feedback: A Grounded Theory Study Exploring Perspectives of Clinical Faculty and Medical Students in Thailand

Cited by 12 publications

References 50 publications

Feedback practices in undergraduate clinical teaching in Sri Lanka - a qualitative study

Feedback practices in undergraduate clinical teaching in Sri Lanka - a qualitative study

Loneliness in Myanmar’s older population: A mixed-methods investigation

Factors affecting perceived credibility of assessment in medical education: A scoping review

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