“How am I doing?” Teaching medical students to elicit feedback during their clerkships

Milan, Felise B.; Dyche, Lawrence; Fletcher, Jason

doi:10.3109/0142159x.2011.588732

Cited by 39 publications

(35 citation statements)

References 25 publications

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“…18,23 Residents also described the importance of the learner in feedback-seeking; specifically, the learner who critically reflected on his or her performance, and demonstrated openness and engagement to feedback, facilitated effective feedback processes. 24,25 While our residents described the importance of continuity in a teacher-learner relationship, they pointed out that logistics and the competing tasks of patient care and education often left little time for feedback. Duty hour restrictions and pressure for faculty to increase their clinical productivity challenge options for maintaining longitudinal relationships between teachers and learners.…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators to Effective Feedback: A Qualitative Analysis of Data From Multispecialty Resident Focus Groups

Reddy¹,

Zegarek²,

Fromme³

et al. 2015

Journal of Graduate Medical Education

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Background Despite the importance of feedback, the literature suggests that there is inadequate feedback in graduate medical education. Objective We explored barriers and facilitators that residents in anesthesiology, emergency medicine, obstetrics and gynecology, and surgery experience with giving and receiving feedback during their clinical training. Methods Residents from 3 geographically diverse teaching institutions were recruited to participate in focus groups in 2012. Open-ended questions prompted residents to describe their experiences with giving and receiving feedback, and discuss facilitators and barriers. Data were transcribed and analyzed using the constant comparative method associated with a grounded theory approach. Results A total of 19 residents participated in 1 of 3 focus groups. Five major themes related to feedback were identified: teacher factors, learner factors, feedback process, feedback content, and educational context. Unapproachable attendings, time pressures due to clinical work, and discomfort with giving negative feedback were cited as major barriers in the feedback process. Learner engagement in the process was a major facilitator in the feedback process. Conclusions Residents provided insights for improving the feedback process based on their dual roles as teachers and learners. Time pressures in the learning environment may be mitigated by efforts to improve the quality of teacher-learner relationships. Forms for collecting written feedback should be augmented by faculty development to ensure meaningful use. Efforts to improve residents' comfort with giving feedback and encouraging learners to engage in the feedback process may foster an environment conducive to increasing feedback.

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Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators to Effective Feedback: A Qualitative Analysis of Data From Multispecialty Resident Focus Groups

Reddy¹,

Zegarek²,

Fromme³

et al. 2015

Journal of Graduate Medical Education

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“…Less attention has been given to the learner's role in seeking feedback. Recent attention in postgraduate medical education has shifted to a more learner-focused model with increased attention to the role of the learner in the feedback exchange (Hattie & Timperley 2007;Boor et al 2008;Watling et al 2008;Watling & Lingard 2010;Bing-You & Trowbridge 2009;Goldman 2009;Teunissen et al 2009Teunissen et al , 2007Krackov 2011;Milan et al 2011). An effective feedback exchange requires learners to be active recipients and seekers of feedback (Teunissen et al 2007).…”

Section: Practice Pointsmentioning

confidence: 99%

Encouraging residents to seek feedback

et al. 2013

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Aim: To explore resident and faculty perceptions of the feedback process, especially residents' feedback-seeking activities. Methods: We conducted focus groups of faculty and residents exploring experiences in giving and receiving feedback, feedbackseeking, and suggestions to support feedback-seeking. Using qualitative methods and an iterative process, all authors analyzed the transcribed audiotapes to identify and confirm themes. Results: Emerging themes fit a framework situating resident feedback-seeking as dependent on four central factors: (1) learning/ workplace culture, (2) relationships, (3) purpose/quality of feedback, (4) emotional responses to feedback. Residents and faculty agreed on many supports and barriers to feedback-seeking. Strengthening the workplace/learning culture through longitudinal experiences, use of feedback forms and explicit expectations for residents to seek feedback, coupled with providing a sense of safety and adequate time for observation and providing feedback were suggested. Tensions between faculty and resident perceptions regarding feedback-seeking related to fear of being found deficient, the emotional costs related to corrective feedback and perceptions that completing clinical work is more valued than learning. Conclusion: Resident feedback-seeking is influenced by multiple factors requiring attention to both faculty and learner roles. Further study of specific influences and strategies to mitigate the tensions will inform how best to support residents in seeking feedback.

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“…Whilst there is evidence that students can be trained to take a more active role in soliciting feedback [20] , it is likely that the increase in feedback-seeking behaviour, whilst potentially impacted by the initiatives and improvement in feedback culture, may also have been a reflection on students' maturation and increased experiences within the clinics over the course of the final year. Few of the students found the portfolio task to be useful; this may be due to pre-existing confidence in seeking and reflecting on feedback in the majority of senior students.…”

Section: Discussionmentioning

confidence: 99%

“…Medical workplaces often lack a culture of feedback, which may be a result of the focus on patient care, practical limitations relating to time and space, and the traditional hierarchical approach to 13 teaching which can restrict dialogue around feedback [4,20,22] . Veterinary students in the early years of the curriculum expect at least the same amount of feedback as they received as high-achieving individuals at school [12] .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, students entering veterinary courses are typically high achievers with ambitious expectations of themselves and others, and who may have been used to receiving high levels of attention whilst at school [12] . Various initiatives for improving the feedback experience in the clinical workplace have been described, including faculty development initiatives [13,17] and training of students in the feedback process [18][19][20] . Additionally, the importance of a culture of feedback within the workplace is paramount [4,[21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

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Initiatives to Improve Feedback Culture in the Final Year of a Veterinary Program

Warman¹,

Laws²,

Crowther³

et al. 2014

Journal of Veterinary Medical Education

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms AbstractDespite the recognised importance of feedback in education, student satisfaction with the feedback process in medical and veterinary programmes is often disappointing. We undertook various initiatives to try to improve the "feedback culture" in the final clinical year of our veterinary programme, focussing on formative verbal feedback. The initiatives included emailed guidelines to staff and students, a faculty development workshop, and a reflective portfolio task for students.Following these initiatives, staff and students were surveyed regarding their perceptions of formative feedback in clinical rotations, and focus groups were held to explore issues further. The amount of feedback appeared to have increased, along with improved recognition of feedback by students and increased staff confidence and competence in the process. Other themes that emerged included inconsistencies in feedback amongst staff and between rotations, difficulties with giving verbal feedback to students particularly when it relates to professionalism, the consequences of feedback for both staff and students, changes and challenges in students' feedback-seeking behaviour, and the difficulties in providing accurate, personal end-of-rotation assessments. This project has helped improve the feedback culture within our clinics; the importance of sustaining and developing this further is discussed.

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“How am I doing?” Teaching medical students to elicit feedback during their clerkships

Abstract: Students can learn to assume a more active role in their learning interactions with instructors during their clerkships.

Cited by 39 publications

References 25 publications

Barriers and Facilitators to Effective Feedback: A Qualitative Analysis of Data From Multispecialty Resident Focus Groups

Barriers and Facilitators to Effective Feedback: A Qualitative Analysis of Data From Multispecialty Resident Focus Groups

Encouraging residents to seek feedback

Initiatives to Improve Feedback Culture in the Final Year of a Veterinary Program

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