Unfulfilled promise, untapped potential: Feedback at the crossroads

Watling, Christopher

doi:10.3109/0142159x.2014.889812

Cited by 74 publications

(88 citation statements)

References 40 publications

(50 reference statements)

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“…Although feedback tends to be positioned as central to effective medical education, many have decried the profession's failure to deliver feedback of sufficient quality to consistently promote performance improvement. [12][13][14] Medicine's chronic frustration with the state of its feedback practices may contribute to coaching's new-found popularity. But in fact, some contemporary models of feedback explicitly emphasise relationship, honest conversation and learner safety in efforts to overcome some of the feedback challenges and render it more useful to learners.…”

Section: Resultsmentioning

confidence: 99%

“…Coaching's unclear relationship with feedback complicates matters further. Although feedback tends to be positioned as central to effective medical education, many have decried the profession's failure to deliver feedback of sufficient quality to consistently promote performance improvement . Medicine's chronic frustration with the state of its feedback practices may contribute to coaching's new‐found popularity.…”

Section: Introductionmentioning

confidence: 99%

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Where philosophy meets culture: exploring how coaches conceptualise their roles

Watling

LaDonna

2019

Medical Education

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Context Although conceptually attractive, coaching in medicine remains ill‐defined, with little examination of the transferability of coaching principles from other fields. Here we explore how coaching is enacted both within and outside of medicine; we aim to understand both the elements required for coaching to be useful and the factors that may influence its translation to the medical education context. Methods In this constructivist grounded theory study, we interviewed 24 individuals across three groups: physicians who consider themselves coaches in clinical learning settings (n = 8), physicians with experience as sports, arts or business coaches (n = 10), and sports coaches without medical backgrounds (n = 6). Data collection and analysis were conducted iteratively using constant comparison to identify themes and explore their relationships. Results We identified a shared philosophy of coaching, comprising three core elements that our participants endorsed regardless of the coaching context: (i) mutual engagement, with a shared orientation towards growth and development; (ii) ongoing reflection involving both learners and coaches, and (iii) an embrace of failure as a catalyst for learning. Enacting these features appeared to be influenced by culture, which affected how coaching was defined and developed, how the coaching role was positioned within the learning context, and how comfortably vulnerability could be expressed. Participants struggled to clearly define the coaching role in medicine, instead acknowledging that the lines between educational roles were often blurred. Further, the embrace of failure appeared challenging in medicine, where showing vulnerability was perceived as difficult for both learners and teachers. Conclusions Medical education's embrace of coaching should be informed by an understanding of both coach and learner behaviours that need to be encouraged and trained, and the cultural and organisational supports that are required to foster success.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Where philosophy meets culture: exploring how coaches conceptualise their roles

Watling

LaDonna

2019

Medical Education

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“…Social, cultural and organisational influences can support or derail efforts to embed meaningful feedback in programmes of learning . Learning environments that afford regular opportunities for teachers to observe learners are more likely to nurture good feedback; in clinical learning environments, however, the pattern is more often one of teachers and learners working in parallel, with limited moments of direct observation . Education programmes that foster teacher–learner relationships also support quality feedback.…”

Section: The Shifting Feedback Conversationmentioning

confidence: 99%

Assessment, feedback and the alchemy of learning

2018

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“…14 This limitation becomes less problematic when external data is provided, discussed and understood prior to discussing goals and next steps. However, in this study, despite providing both the data and the opportunity to understand and apply the data, [48][49][50][51] some residents appeared unable or unwilling to translate the discussion into developing an action plan. In this case, supervisors may need to take a more directive approach.…”

Section: Self-direction Versus Ensuring Progression To Competencementioning

confidence: 99%

Identifying coaching skills to improve feedback use in postgraduate medical education

et al. 2019

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Objectives Coaching in medical education has recently gained prominence, but minimal attention has been given to key skills and determining how they work to effectively ensure residents are progressing and developing self‐assessment skills. This study examined process‐oriented and content‐oriented coaching skills used in coaching sessions, with particular attention to how supervisors use them to enhance resident acceptance of feedback to enhance learning. Methods This qualitative study analysed secondary audiotaped data from 15 supervisors: resident dyads during two feedback sessions, 4 months apart. The R2C2 model was used to engage the resident, build a relationship, explore reactions to feedback, explore resident perceptions of content, and coach for change. Framework analysis was used, including familiarisation with the data, identifying the thematic framework, indexing and charting the data and mapping and interpretation. Results Process skills included preparation, relationship development, using micro communication skills and techniques to promote reflection and self‐assessment by the resident and supervisor flexibility. Content skills related to the specific feedback content included engaging the resident in discussion, ensuring the discussion was collaborative and focused on goal setting, co‐developing a Learning Change Plan, ensuring resident commitment and following up on the plan. Together, these skills foster agency in the resident learner. Three overarching themes emerged from the analysis: the interconnectedness of process and content; tensions between encouraging self‐direction and ensuring progress and competence; and balancing a coaching dialogue and a teaching monologue. Conclusions Effective coaching by supervisors requires a combination of specific process and content skills that are chosen depending on the needs of the individual resident. Mastering these skills helps residents engage and develop agency in their own professional development. These outcomes depend on faculty maintaining a balance between coaching and teaching, encouraging resident self‐direction and ensuring progression to competence.

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Unfulfilled promise, untapped potential: Feedback at the crossroads

Cited by 74 publications

References 40 publications

Where philosophy meets culture: exploring how coaches conceptualise their roles

Where philosophy meets culture: exploring how coaches conceptualise their roles

Assessment, feedback and the alchemy of learning

Identifying coaching skills to improve feedback use in postgraduate medical education

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