Abstract:Trainees' perceptions of the purpose of WBA and their relationship with their trainer informed when they chose to seek feedback. Trainees who perceived WBA as a test were led to 'play the game' by seeking positive and avoiding negative feedback. Outside of WBA, trainees sought negative feedback, which was most important for change in practice.
“…They reported that the assessment messages they received were fair and useful, and promoted deeper understanding and learning . One trainee commented:…if it is done well you can get an awful lot of learning opportunities out of it and …it gives you an awful lot of feedback.…”
Section: Resultsmentioning
confidence: 99%
“……if it is done well you can get an awful lot of learning opportunities out of it and …it gives you an awful lot of feedback.…”
Section: Resultsmentioning
confidence: 99%
“…Others highlighted the limitations of positive feedback:…positive feedback is nice but it's not always going to be productive for you.…”
Section: Resultsmentioning
confidence: 99%
“…A trainee in another study observed:But the majority of consultants will just sort of go ‘Oh God, you want one of these again’. Fill it in really quickly, give you no feedback whatsoever and it is just a tick box.…”
Section: Resultsmentioning
confidence: 99%
“…Wrongly or rightly, this left some trainees to infer from their feedback:…if nobody has criticised you or had a go at you then you know you are alright.…”
Objectives
This study was designed as a narrative systematic literature review of medical specialist trainees’ perspectives of the assessment messages they receive in the context of clinical performance assessments. The aim of the study was to determine if trainees value the information they receive through the formats designed to promote their development and, if not, the reasons for this.
Methods
The authors searched the ERIC, EMBASE, Ovid MEDLINE and PsycINFO databases for articles published up to 16 June 2018 that present original data on trainees’ perspectives of the assessment messages they receive in the context of work‐based assessments (WBAs) and in‐training assessments (ITAs) used within their training programmes. All authors screened 938 abstracts and 139 full‐text articles were assessed after this. Descriptions of quantitative data and thematic analysis of qualitative data were used to present the opinions of trainees.
Results
Thirty‐three articles met the inclusion criteria. Twenty‐six articles (79%) described trainees’ perspectives in the context of WBA and the remaining articles referred to ITA formats. Wide‐ranging opinions were reported. The analysis categorised these into three themes: trainees value developmental assessment messages; trainees become disengaged when assessment messages are not developmental, and trainees’ views depend on the environment, the assessor and themselves. Some trainees reported that the assessment messages were valuable and provided input on their performance to guide their development, but many disagreed. In particular, the trainee's own level of engagement with the assessments influenced his or her perspectives on the messages received.
Conclusions
Trainees do not universally perceive that clinical performance assessments provide them with the valuable developmental input on their performance they were designed to do. Factors related to the environment, the assessor and themselves influence their perspectives.
“…They reported that the assessment messages they received were fair and useful, and promoted deeper understanding and learning . One trainee commented:…if it is done well you can get an awful lot of learning opportunities out of it and …it gives you an awful lot of feedback.…”
Section: Resultsmentioning
confidence: 99%
“……if it is done well you can get an awful lot of learning opportunities out of it and …it gives you an awful lot of feedback.…”
Section: Resultsmentioning
confidence: 99%
“…Others highlighted the limitations of positive feedback:…positive feedback is nice but it's not always going to be productive for you.…”
Section: Resultsmentioning
confidence: 99%
“…A trainee in another study observed:But the majority of consultants will just sort of go ‘Oh God, you want one of these again’. Fill it in really quickly, give you no feedback whatsoever and it is just a tick box.…”
Section: Resultsmentioning
confidence: 99%
“…Wrongly or rightly, this left some trainees to infer from their feedback:…if nobody has criticised you or had a go at you then you know you are alright.…”
Objectives
This study was designed as a narrative systematic literature review of medical specialist trainees’ perspectives of the assessment messages they receive in the context of clinical performance assessments. The aim of the study was to determine if trainees value the information they receive through the formats designed to promote their development and, if not, the reasons for this.
Methods
The authors searched the ERIC, EMBASE, Ovid MEDLINE and PsycINFO databases for articles published up to 16 June 2018 that present original data on trainees’ perspectives of the assessment messages they receive in the context of work‐based assessments (WBAs) and in‐training assessments (ITAs) used within their training programmes. All authors screened 938 abstracts and 139 full‐text articles were assessed after this. Descriptions of quantitative data and thematic analysis of qualitative data were used to present the opinions of trainees.
Results
Thirty‐three articles met the inclusion criteria. Twenty‐six articles (79%) described trainees’ perspectives in the context of WBA and the remaining articles referred to ITA formats. Wide‐ranging opinions were reported. The analysis categorised these into three themes: trainees value developmental assessment messages; trainees become disengaged when assessment messages are not developmental, and trainees’ views depend on the environment, the assessor and themselves. Some trainees reported that the assessment messages were valuable and provided input on their performance to guide their development, but many disagreed. In particular, the trainee's own level of engagement with the assessments influenced his or her perspectives on the messages received.
Conclusions
Trainees do not universally perceive that clinical performance assessments provide them with the valuable developmental input on their performance they were designed to do. Factors related to the environment, the assessor and themselves influence their perspectives.
Background
Feedback is a pivotal cornerstone and a challenge in psychomotor training. There are different teaching methodologies; however, some may be less effective.
Methods
A prospective randomized controlled trial was conducted in 130 medical students to compare the effectiveness of the video‐guided learning (VLG), peer‐feedback (PFG) and the expert feedback (EFG) for teaching suturing skills. The program lasted 4 weeks. Students were recorded making 3‐simple stitches (pre‐assessment and post‐assessment). The primary outcome was a global scale (OSATS). The secondary outcomes were performance time, specific rating scale (SRS) and the impact of the intervention (IOI), defined as the variation between the final and initial OSATS and SRS scores.
Results
No significant differences were found between PFG and EFG in post‐assessment results of OSATS, SRS scores or in the IOI for OSATS and SRS scores. Post‐assessment results of PFG and EFG were significantly superior to VLG in OSATS and SRS scores [(19.8 (18.5–21); 16.6 (15.5–17.5)) and (20.3 (19.88–21); 16.8 (16–17.5)) vs (15.7 (15–16); 13.3 (12.5–14)) (p < 0.05)], respectively. The results of PFG and EFG were significantly superior to VLG in the IOI for OSATS [7 (4.5–9) and 7.4 (4.88–10) vs 3.5 (1.5–6) (p < 0.05)] and SRS scores [5.4 (3.5–7) and 6.3 (4–8.5) vs 3.1 (1.13–4.88) (p < 0.05)], respectively.
Conclusion
The video‐guided learning methodology without any kind of feedback is not enough for teaching suturing skills compared to expert or peer feedback. The peer feedback methodology appears to be a viable alternative to handling the emerging demands in medical education.
If used thoughtfully and with intent, feedback and coaching will promote learning and growth as well as personal and professional development in our learners. Feedback is an educational tool as well as a social interaction between learner and supervisor, in the context of a respectful and trusting relationship. It challenges the learner’s thinking and supports the learner’s growth. Coaching is an educational philosophy dedicated to supporting learners’ personal and professional development and growth and supporting them to reach their potential. In clinical education, feedback is most effective when it is explicitly distinguished from summative assessment. Importantly, feedback should be about firsthand observed behaviors (which can be direct or indirect) and not about information which comes from a third party. Learners are more receptive to feedback if it comes from a source that they perceive as credible, and with whom they have developed rapport. The coaching relationship between learner and supervisor should also be built on mutual trust and respect. Coaching can be provided in the moment (feedback on everyday clinical activities that leads to performance improvement, even with short interaction with a supervisor) and over time (a longer term relationship with a supervisor in which there is reflection on the learner’s development and co-creation of new learning goals). Feedback and coaching are most valuable when the learner and teacher exhibit a growth mindset. At the organizational level, it is important that both the structures and training are in place to ensure a culture of effective feedback and coaching in the clinical workplace.Conclusions: Having a thoughtful and intentional approach to feedback and coaching with learners, as well as applying evidence-based principles, will not only contribute in a significant way to their developmental progression, but will also provide them with the tools they need to have the best chance of achieving competence throughout their training.
What is Known:• Feedback and coaching are key to advancing the developmental progression of trainees as they work towards achieving competence.• Feedback is not a one-way delivery of specific information from supervisor to trainee, but rather a social interaction between two individuals in which trust and respect play a key role.• Provision of effective feedback may be hampered by confusing formative (supporting trainee learning and development) and summative (the judgment that is made about a trainee’s level of competence) purposes.
What is New:• Approaches to both the provision of feedback/coaching and the assessment of competence must be developed in parallel to ensure success in clinical training programs.• Faculty development is essential to provide clinical teachers with the skills to provide effective feedback and coaching.• Coaching’s effectiveness relies on nurturing strong trainee-supervisor relationships, ensuring high-quality feedback, nourishing a growth mindset, and encouraging an institutional culture that embraces feedback and coaching.
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