What we've got here is failure to communicate: Exploring perceptions of how much feedback is happening in clinical workplace teaching

Abstract

Introduction: Feedback is invaluable in helping learners improve their performance and clinical competence, but studies have historically documented contrasting perspectives between learners and teachers in how much feedback is given by teachers to learners in clinical training. We explore why there is a discrepancy between learner and teacher perceptions of the feedback that is shared in a clinical teaching encounter. Methods: We recruited 23 preceptors (clinical teachers) from a mid-size Canadian medical school that has a diverse group of generalist and focused specialties. We used inductive content analysis to explore preceptors’ perceptions of both how much feedback they shared with learners, as well as amount of feedback that they believe learners would report was shared. Results: Analysis of interviews generated two themes: (i) difficulty among preceptors in quantifying the feedback they share to learners, and; (ii) discrepancies between preceptors in the definition of feedback. Discussion: The key themes identified in this study highlight that preceptors’ varying definitions of feedback and their difficulty in ascertaining how much feedback they share with learners can be attributed to a lack of a common understanding of feedback. When engaging in a feedback conversation, both the teacher and the learner engage in a meaning-making process that yields a shared understanding that feedback is occurring, and that information offered by the teacher is aimed at supporting the learner. We recommend that both faculty development sessions and educational sessions with learners should incorporate early check-ins to ensure a shared understanding of the definition of feedback.