Uncovering the unknown: A grounded theory study exploring the impact of self-awareness on the culture of feedback in residency education

Ramani, Subha; Könings, Karen D.; Mann, Karen; Vleuten, Cees van der

doi:10.1080/0142159x.2017.1353071

Cited by 37 publications

(43 citation statements)

References 56 publications

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“…Miller's pyramid of competence suggests that despite good knowledge being foundational to achieving proficient clinical skills, clinical skills are at a higher level compared to knowledge (Shumway et al, 2003). The phenomenon is also relevant to the theory of competency development and internalization, the Johari's Window (Ramani et al, 2017). Individuals with good knowledge might understand their limitations so that they are 'conscious incompetent'.…”

Section: General Practitioners' Perspective and Associated Factorsmentioning

confidence: 99%

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Confidence in managing human monkeypox cases in Asia: A cross-sectional survey among general practitioners in Indonesia

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Section: General Practitioners' Perspective and Associated Factorsmentioning

confidence: 99%

“…Nevertheless, this less-confident attitude is a good entry point for implementing a reflective learning practice (Ramani et al, 2017), to advance from being an 'unconscious incompetent' to a 'conscious competent' through an experiential learning journey (Yardley et al, 2012).…”

Section: General Practitioners' Perspective and Associated Factorsmentioning

confidence: 99%

Confidence in managing human monkeypox cases in Asia: A cross-sectional survey among general practitioners in Indonesia

et al. 2020

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“…Sociocultural factors that influence feedback include: teacher characteristics, teacher-learner relationships, observation of performance, learner self-efficacy, autonomy, feedback seeking and acceptance, and perceived credibility of feedback data (Sargeant et al 2007(Sargeant et al , 2008aDelva et al 2011;Mann et al 2011;Sargeant et al 2011;Eva et al 2012;Watling et al 2013aWatling et al , 2014Watling 2014aWatling , 2014bWatling , 2016Ramani, et al 2017aRamani, et al , 2017bRamani, et al , 2019. Self-assessment and reflection are also central to feedback seeking and acceptance (Sargeant et al 2008b(Sargeant et al , 2009K€ onings et al 2016).…”

Section: Feedback As a Sociocultural Phenomenonmentioning

confidence: 99%

“…The window features four quadrants: open-known to self and others, blind-known to others but unknown to self, hidden-known to self but unknown to others, and unknown-unknown to self and others ( Figure 4). To enhance self-awareness, learners should seek feedback to learn about behaviours that they are unaware of, disclose limitations for teachers to provide accurate feedback based on context, and engage in selfdiscovery through acceptance of performance data from multiple sources to bring unknown areas to light (Ramani et al 2017a).…”

Section: Self-factors and Feedback (Learner)mentioning

confidence: 99%

Meaningful feedback through a sociocultural lens

et al. 2019

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This AMEE guide provides a framework and practical strategies for teachers, learners and institutions to promote meaningful feedback conversations that emphasise performance improvement and professional growth. Recommended strategies are based on recent feedback research and literature, which emphasise the sociocultural nature of these complex interactions. We use key concepts from three theories as the underpinnings of the recommended strategies: sociocultural, politeness and self-determination theories. We view the content and impact of feedback conversations through the perspective of learners, teachers and institutions, always focussing on learner growth. The guide emphasises the role of teachers in forming educational alliances with their learners, setting a safe learning climate, fostering self-awareness about their performance, engaging with learners in informed self-assessment and reflection, and co-creating the learning environment and learning opportunities with their learners. We highlight the role of institutions in enhancing the feedback culture by encouraging a growth mind-set and a learning goal-orientation. Practical advice is provided on techniques and strategies that can be used and applied by learners, teachers and institutions to effectively foster all these elements. Finally, we highlight throughout the critical importance of congruence between the three levels of culture: unwritten values, espoused values and day to day behaviours.

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“…The idea is that different feedback is given when a person functions in the role of manager rather than educator. Ramani et al offered a different perspective that focuses on the content of the feedback classified according to the Johari window, which is a classification of self-awareness into the known, the unknown, the hidden and the blind [63]. These approaches share an interest in an underexplored issue in these conversations, namely how the agenda is selected and from what perspective is the problem approached.…”

Section: Alternative Perspectivesmentioning

confidence: 99%

Finding common ground: meta-synthesis of communication frameworks found in patient communication, supervision and simulation literature

et al. 2020

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Background: Effective communication between patients-clinicians, supervisors-learners and facilitators-participants within a simulation is a key priority in health profession education. There is a plethora of frameworks and recommendations to guide communication in each of these contexts, and they represent separate discourses with separate communities of practice and literature. Finding common ground within these frameworks has the potential to minimise cognitive load and maximise efficiency, which presents an opportunity to consolidate messages, strategies and skills throughout a communication curriculum and the possibility of expanding the research agenda regarding communication, feedback and debriefing in productive ways. Methods: A meta-synthesis of the feedback, debriefing and clinical communication literature was conducted to achieve these objectives. Results: Our analysis revealed that the concepts underlying the framework can be usefully categorised as stages, goals, strategies, micro-skills and meta-skills. Guidelines for conversations typically shared a common structure, and strategies aligned with a stage. Core transferrable communication skills (i.e., micro-skills) were identified across various types of conversation, and the major differences between frameworks were related to the way that power was distributed in the conversation and the evolution of conversations along the along the path of redistributing power. As part of the synthesis, an overarching framework "prepare-EMPOWER enact" was developed to capture these shared principles across discourses. Conclusions: Adopting frameworks for work-based communication that promote dialogue and empower individuals to contribute may represent an important step towards learner-centred education and person-centred care for patients.

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Uncovering the unknown: A grounded theory study exploring the impact of self-awareness on the culture of feedback in residency education

Abstract: The Johari window, a model of self-awareness in interpersonal communications, could provide a robust framework for individuals to improve their feedback conversations and institutions to design feedback initiatives that enhance its quality and impact.

Cited by 37 publications

References 56 publications

Confidence in managing human monkeypox cases in Asia: A cross-sectional survey among general practitioners in Indonesia

Confidence in managing human monkeypox cases in Asia: A cross-sectional survey among general practitioners in Indonesia

Meaningful feedback through a sociocultural lens

Finding common ground: meta-synthesis of communication frameworks found in patient communication, supervision and simulation literature

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