The Practice of Feedback in Health Professions Education in the Hierarchical and Collectivistic Culture: a Scoping Review

Soemantri, Diantha; Nurokhmanti, Hikmawati; Qomariyah, Nurul; Claramita, Mora

doi:10.1007/s40670-022-01597-8

Cited by 7 publications

(8 citation statements)

References 40 publications

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“…Indonesia currently has 93 medical schools across Indonesia, with the main medical schools located on Java Island, the country’s most populated and well-developed island. The medical schools in Indonesia have very different contexts, cultures, facilities, and resources, which affects the way they academically adapt in response to the COVID-19, however, generally Indonesia has high power distance and high collectivistic cultural dimensions [ 16 , 17 ], which to some extent would influence student-teacher relationships. Students in Indonesia can enter medical school directly after graduating high school.…”

Section: Methodsmentioning

confidence: 99%

Looking beyond the COVID-19 pandemic: the recalibration of student-teacher relationships in teaching and learning process

Soemantri,

Findyartini,

Mustika

et al. 2023

Medical Education Online

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Background Given the various novel educational approaches and online interactions following the pandemic, it is timely to identify lessons learned for post-pandemic student and teacher relationships within the ‘new normal’ teaching learning processes. This study aims to explore the dynamics and to what extent the disruption influences student-teacher relationships in teaching and learning process following the COVID-19 pandemic. Materials and Methods A qualitative descriptive approach was employed to explore individual reflections and perspectives from 28 medical teachers and 35 medical students from different institutions who participated in 10 focus groups. Data were analyzed thematically using steps for coding and theorization (SCAT) approach. The emerging themes were then further analyzed and regrouped into the relationship-centered leadership framework based on emotional intelligence. Results The identified themes described three elements representing student-teacher relationships in the teaching learning processes. The self as the center of the diagram consists of the co-existing role of the self as teachers and as students, which to some extent, is related to their personal and professional development, motivation, and struggles to maintain work-life balance. The middle layer represents the dynamic of student-teacher relationship, which showed that despite the increased number of teaching opportunities, the trust among teachers and students was compromised. These changes in the self and the dynamic relationship occurred in a broader and more complex medical education system, pictured as the outer layer. Thorough curriculum improvements, contents, and new skills were emphasized. Conclusions Our findings emphasized the need to recalibrate student-teacher relationships, taking into account the intrapersonal, interpersonal, and the system factors. The pandemic has reemphasized the aim of teachers’ roles, not only to nurture students’ competencies, but also to nurture meaningful interpersonal reciprocal relationships through responding towards both teachers’ and students’ needs as well as supporting both personal and professional development.

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Section: Methodsmentioning

confidence: 99%

Looking beyond the COVID-19 pandemic: the recalibration of student-teacher relationships in teaching and learning process

Soemantri,

Findyartini,

Mustika

et al. 2023

Medical Education Online

Self Cite

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“…Studies show that learning and organizational cultures contribute to feedback-seeking behaviors where the teachers’ initiatives and positions as experts are critical in a hierarchical culture [ 9 , 10 ]. It is also found that unidirectional and top-down feedback is more prominent in the hierarchical culture, including in Indonesia as the setting of this study [ 15 , 16 ]. Hierarchical culture is characterized by a gap created by the social power structure due to people’s older age, knowledge, and positions.…”

Section: Backgroundsmentioning

confidence: 98%

Challenges and opportunities in cultivating medical students’ competencies: Participatory action research from a hierarchical cultural setting

Findyartini

Syah

Susilo

et al. 2023

Medical Education Online

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Backgrounds Research concerning student-centered learning (SCL) recommends a comprehensive assessment of medical students’ competencies including their personal and professional characters. Accordingly, nurturing future doctors should be in a continuous mentorship program. However, in a hierarchical culture, communication is one-way with limited feedback and reflection. We aimed to explore challenges and opportunities for SCL implementation in medical schools in this cultural setting necessary for a globally interdependent world. Methods Two cycles of participatory action research (PAR) were conducted, involving medical students and teachers in Indonesia. A national conference on SCL principles was conducted between the cycles, also the SCL modules were developed for each institution and feedback was shared. Twelve focus group discussions were conducted (before and after the module development), with 37 medical teachers and 48 medical students from 7 faculties of medicine across Indonesia at various levels accreditation. Following verbatim transcriptions, a thematic analysis was conducted. Results and Discussions In cycle 1 PAR, some challenges in implementing SCL were identified: lack of constructive feedback, overloaded content, summative-based assessment, hierarchical culture environment, and teachers’ dilemma of committed time between patient-care and education. In cycle 2, several opportunities to approach the SCL were proposed: a faculty development program on mentorship, students’ reflection guides and training, a more longitudinal assessment system, also a more supportive government policy on the human resources system. Conclusions The main challenge of fostering student-centered learning revealed in this study was a teacher-centered learning tendency in the medical curriculum. The weighting towards summative assessment and the national educational policy drive the curriculum like a ‘domino effect’, away from the expected student-centered learning principles. However, using a participative method, students and teachers could identify opportunities and articulate their educational needs, i.e., a partnership-mentorship program, as a significant step toward student-centered learning in this cultural context.

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“…Moreover, written commentary can have less impact on competency judgments than quantitative metrics [ 5 ]. Environmental factors that negatively impact clinical teaching and feedback practices are not unique to Western countries; they have also been observed in Asia, where hierarchical and collectivist culture may also play a role [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Discovering social learning ecosystems during clinical clerkship from United States medical students’ feedback encounters: a content analysis

Cianciolo,

Han,

Howes

et al. 2024

J Educ Eval Health Prof

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Purpose: We examined United States medical students’ self-reported feedback encounters during clerkship training to better understand in situ feedback practices. Specifically, we asked: Who do students receive feedback from, about what, when, where, and how do they use it? We explored whether curricular expectations for preceptors’ written commentary aligned with feedback as it occurs naturalistically in the workplace.Methods: This study occurred from July 2021 to February 2022 at Southern Illinois University School of Medicine. We used qualitative survey-based experience sampling to gather students’ accounts of their feedback encounters in 8 core specialties. We analyzed the who, what, when, where, and why of 267 feedback encounters reported by 11 clerkship students over 30 weeks. Code frequencies were mapped qualitatively to explore patterns in feedback encounters.Results: Clerkship feedback occurs in patterns apparently related to the nature of clinical work in each specialty. These patterns may be attributable to each specialty’s social learning ecosystem—the distinctive learning environment shaped by the social and material aspects of a given specialty’s work, which determine who preceptors are, what students do with preceptors, and what skills or attributes matter enough to preceptors to comment on. Conclusion: Comprehensive, standardized expectations for written feedback across specialties conflict with the reality of workplace-based learning. Preceptors may be better able—and more motivated—to document student performance that occurs as a natural part of everyday work. Nurturing social learning ecosystems could facilitate workplace-based learning such that, across specialties, students acquire a comprehensive clinical skillset appropriate for graduation.

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The Practice of Feedback in Health Professions Education in the Hierarchical and Collectivistic Culture: a Scoping Review

Cited by 7 publications

References 40 publications

Looking beyond the COVID-19 pandemic: the recalibration of student-teacher relationships in teaching and learning process

Looking beyond the COVID-19 pandemic: the recalibration of student-teacher relationships in teaching and learning process

Challenges and opportunities in cultivating medical students’ competencies: Participatory action research from a hierarchical cultural setting

Discovering social learning ecosystems during clinical clerkship from United States medical students’ feedback encounters: a content analysis

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