Patient Feedback Requirements for Medical Students: Do Perceived Risks Outweigh the Benefits?

Abstract

Patient feedback has increasingly become part of medical students' training and formative assessment. We conducted a qualitative study using focus groups to explore students' experiences soliciting patient feedback, including the benefits, challenges, and potential strategies to obtain it. Fifteen medical students participated. Thematic analysis revealed students' (1) discomfort soliciting feedback and concern of being viewed as self-serving; (2) concerns about eroding patient trust; (3) indifference to nonspecific, positive feedback; and (4) belief that informally solicited feedback is most helpful for their learning. Strategies for soliciting more useful patient feedback included (1) team-based solicitation, (2) empowering patients as teachers, and (3) development of feedback instruments that allow patients to comment on specific student-identified learning goals. Solicitation of patient feedback is challenging for medical students and provokes discomfort. Strategies to integrate patient feedback into medical student training and assessment must attend to students' needs so the value of patient feedback can be realized.

Let’s ask the patient – composition and validation of a questionnaire for patients’ feedback to medical students

“…The authors of previous studies and patient surveys have often advocated for anonymous patient feedback as a favourable approach to creating a safe environment in which to provide feedback regarding patients’ subjective experiences of an encounter [ 12 , 30 ]. In the current study, patients were not anonymous, which could have affected their willingness both to participate in the study and provide feedback due to their plausible dependability upon their caregiver [ 19 , 47 ]. The patients in this study indicated that the items’ content gave them opportunities to respond to specific aspects of an encounter and to assess concrete, non-emotional aspects of their experience.…”

“…Students’ clinical supervisors are often the main providers of feedback regarding communication and patient-centeredness [ 18 ]. Patients’ participation in medical education can facilitate students’ abilities to evaluate their own communication and patient-centeredness proficiencies, positively influencing patients’ experiences of healthcare [ 19 , 20 ]. Traditionally, patients’ involvement in medical education has been passive and objectified, hence illustrating specific conditions or clinical findings [ 20 ].…”

“…Over the last decades, patients’ involvement in various levels of medical education has evolved [ 21 , 22 ]. However, patients seldom participate on a regular basis in medical students’ learning by providing feedback that directly targets knowledge and skills regarding communication and patient-centeredness from the patient’s perspective during a patient encounter [ 19 , 23 ]. Research has shown that medical students often experience patients’ written feedback as generally encouraging, moderate, and positive [ 19 ] and more seldom as a substantial source of information that identifies students’ knowledge levels and knowledge gaps [ 24 , 25 ].…”

Exploring how differently patients and clinical tutors see the same consultation: building evidence for inclusion of real patient feedback in medical education

“…Our study pinpoints the elements of the consultation where they are providing a unique and valuable perspective. This responds to Chua and Bogetz's [18] call for patients to be empowered to see themselves as teachers who have an impact on student learning through feedback.…”

“…References to multisource feedback in medical student learning tend to focus on peer and self-assessment, not patient assessment. However recently, Chua and Bogetz [18] shifted their focus from the post-graduate realm to explore medical students' solicitation of patient feedback in the acute setting and this work provides useful insights which can guide processes for students seeking meaningful patient feedback. Despite this, understanding what perspective-specific role patients play as a feedback source in medical school learning environments has yet to be fully investigated in terms of specifically what students can expect from patients that may be different to what they receive from their clinical tutors, to enable them to synthesise and utilise such feedback in their development.…”