Self and peer feedback engagement and receptivity among medical students with varied academic performance in the clinical skills laboratory.
Clinical skills laboratory
Educational feedback interventions
Feedback engagement
Medical education
Peer feedback
Self-assessment feedback
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
28 Sep 2024
28 Sep 2024
Historique:
received:
22
02
2024
accepted:
25
09
2024
medline:
29
9
2024
pubmed:
29
9
2024
entrez:
28
9
2024
Statut:
epublish
Résumé
Medical students benefit from direct observation of clinical performance and timely feedback from multiple sources. While self and peer feedback have been the focus of numerous research studies, how they influence feedback engagement and receptivity in medical students of varying achievement levels in the clinical skills laboratory setting remains relatively unexplored. We conducted an exploratory qualitative study to investigate students' engagement and receptivity to self and peer feedback across academic performance levels at a medical teaching institution. Data from five focus groups with third-year medical students(n = 25) were thematically analysed. The ways in which low and high performing students engaged with self-assessment and peer feedback were divided into three categories: affective (or interpersonal), orientational, and transformational. Lower achievers believed they lacked the necessary skills to effectively engage in self and peer feedback interventions, but they agreed with higher achievers who recognized that peer feedback combined with prior knowledge of learning objectives allowed them to take ownership of monitoring their own development over time. Learners' emotional maturity in response to feedback ratings and feedback from activities testing clinical cognition had an impact on self-regulated learning. Creating a trusting environment is critical for improving the acceptability of peer feedback. It is also critical to provide multiple opportunities for self-assessment in order to improve one's judgment. Giving learners the ability to actively seek and engage with feedback encourages participation in the feedback cycle, focusing on self-regulation rather than reliance on feedback providers. Feedback and action plan development can be improved by teaching students how to understand criticism, manage emotions constructively, and practice developing evaluative judgment and self-regulation skills. Based on the study findings an integrated three stage training model is recommended for effective self- and peer feedback practice for undergraduate medical education.
Sections du résumé
BACKGROUND
BACKGROUND
Medical students benefit from direct observation of clinical performance and timely feedback from multiple sources. While self and peer feedback have been the focus of numerous research studies, how they influence feedback engagement and receptivity in medical students of varying achievement levels in the clinical skills laboratory setting remains relatively unexplored.
METHODS
METHODS
We conducted an exploratory qualitative study to investigate students' engagement and receptivity to self and peer feedback across academic performance levels at a medical teaching institution. Data from five focus groups with third-year medical students(n = 25) were thematically analysed.
RESULTS
RESULTS
The ways in which low and high performing students engaged with self-assessment and peer feedback were divided into three categories: affective (or interpersonal), orientational, and transformational. Lower achievers believed they lacked the necessary skills to effectively engage in self and peer feedback interventions, but they agreed with higher achievers who recognized that peer feedback combined with prior knowledge of learning objectives allowed them to take ownership of monitoring their own development over time. Learners' emotional maturity in response to feedback ratings and feedback from activities testing clinical cognition had an impact on self-regulated learning.
CONCLUSIONS
CONCLUSIONS
Creating a trusting environment is critical for improving the acceptability of peer feedback. It is also critical to provide multiple opportunities for self-assessment in order to improve one's judgment. Giving learners the ability to actively seek and engage with feedback encourages participation in the feedback cycle, focusing on self-regulation rather than reliance on feedback providers. Feedback and action plan development can be improved by teaching students how to understand criticism, manage emotions constructively, and practice developing evaluative judgment and self-regulation skills. Based on the study findings an integrated three stage training model is recommended for effective self- and peer feedback practice for undergraduate medical education.
Identifiants
pubmed: 39342246
doi: 10.1186/s12909-024-06084-9
pii: 10.1186/s12909-024-06084-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1065Informations de copyright
© 2024. The Author(s).
Références
Carless D, Boud D. The development of student feedback literacy: enabling uptake of feedback. Assess Eval High Educ. 2018;43(8):1315–25. https://doi.org/10.1080/02602938.2018.1463354 .
doi: 10.1080/02602938.2018.1463354
Boud D, Molloy E. Rethinking models of feedback for learning: the challenge of design. Assess Eval High Educ. 2013;38(6):698–712. https://doi.org/10.1080/02602938.2012.691462 .
doi: 10.1080/02602938.2012.691462
Kluger A, DeNisi A. The effects of feedback interventions on performance: a historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychol Bull. 1996;119(2):254–84. https://doi.org/10.1037/0033-2909.119.2.254 .
doi: 10.1037/0033-2909.119.2.254
Zimmerman BJ. Becoming a self-regulated learner: an overview. Theory Pract. 2002;41(2):64–70. https://doi.org/10.1207/s15430421tip4102_2 .
doi: 10.1207/s15430421tip4102_2
Winstone NE, Nash RA, Parker M, Rowntree J. Supporting learners’ agentic engagement with feedback: a systematic review and a taxonomy of recipience processes. Educ Psychol. 2017;52(1):17–37. https://doi.org/10.1080/00461520.2016.1207538 .
doi: 10.1080/00461520.2016.1207538
Nicol D. From monologue to dialogue: improving written feedback processes in mass higher education. Assess Eval High Educ. 2010;35(5):501–17. https://doi.org/10.1080/02602931003786559 .
doi: 10.1080/02602931003786559
Hattie J, Timperley H. The power of feedback. Rev Educ Res. 2007;77(1):81–112.
doi: 10.3102/003465430298487
Yan Z, Carless D. Self-assessment is about more than self: the enabling role of feedback literacy. Assess Eval High Educ. 2021;47(7):1116–28. https://doi.org/10.1080/02602938.2021.2001431 .
doi: 10.1080/02602938.2021.2001431
Mann K, Gordon J, Macleod A. Reflection and reflective practice in health professions education: a systematic review. Adv Health Sci Educ. 2009;14:595–621.
doi: 10.1007/s10459-007-9090-2
van de Ridder JM, McGaghie WC, Stokking KM, ten Cate OT. Variables that affect the process and outcome of feedback, relevant for medical training: a meta-review. Med Educ. 2015;49(7):658–73. https://doi.org/10.1111/medu.12752 .
doi: 10.1111/medu.12752
Ferguson J, Wakeling J, Bowie P. Factors influencing the effectiveness of multisource feedback in improving the professional practice of medical doctors: a systematic review. BMC Med Educ. 2014;14:76. https://doi.org/10.1186/1472-6920-14-76 .
doi: 10.1186/1472-6920-14-76
Curran VR, Fairbridge NA, Deacon D. Peer assessment of professionalism in undergraduate medical education. BMC Med Educ. 2020;20:504. https://doi.org/10.1186/s12909-020-02412-x .
doi: 10.1186/s12909-020-02412-x
Lerchenfeldt S, Taylor TAH. Best practices in peer assessment: training tomorrow’s physicians to obtain and provide quality feedback. Adv Med Educ Pract. 2020;25(11):571–8. https://doi.org/10.2147/AMEP.S250761.PMID:32922116;PMCID:PMC7457869 .
doi: 10.2147/AMEP.S250761.PMID:32922116;PMCID:PMC7457869
Cordovani L, Tran C, Wong A, et al. Undergraduate learners’ receptiveness to feedback in medical schools: a scoping review. Med Sci Educ. 2023;33(5):1253–69. https://doi.org/10.1007/s40670-023-01858-0 .
doi: 10.1007/s40670-023-01858-0
Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs: Prentice Hall; 1984. Retrieved from http://www.learningfromexperience.com/images/uploads/process-ofexperiential-learning.pdf . Accessed 31 May 2020.
Vygotsky LS. Mind in society: the development of higher psychological processes. Cambridge, MA: Harvard University Press; 1978.
Eppich W, Cheng A. Promoting excellence and reflective learning in simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simul Healthc. 2015;10(2):106–15.
doi: 10.1097/SIH.0000000000000072
Patton MQ. Qualitative research and evaluation methods: integrating theory and practice. 4th ed. Thousand Oaks, CA: Sage; 2015.
Kozato A, Shikino K, Matsuyama Y, et al. A qualitative study examining the critical differences in the experience of and response to formative feedback by undergraduate medical students in Japan and the UK. BMC Med Educ. 2023;23:408. https://doi.org/10.1186/s12909-023-04257-6 .
doi: 10.1186/s12909-023-04257-6
Price M, Rust C, O’Donovan B, Handley K, Bryant R. Assessment literacy: the foundation for improving student learning. Oxford: Oxford Centre for Staff and Learning Development; 2012.
Jonsson A. Facilitating productive use of feedback in higher education. Act Learn High Educ. 2013;14:63–76. https://doi.org/10.1177/1469787412467125 .
doi: 10.1177/1469787412467125
Boud D, Lawson R, Thompson D. Does student engagement in self-assessment calibrate their judgement over time? Assess Eval High Educ. 2013;38(8):941–56.
doi: 10.1080/02602938.2013.769198
Richardson M, Abraham C, Bond R. Psychological correlates of university students’ academic performance: a systematic review and meta-analysis. Psychol Bull. 2012;138(2):353–87. https://doi.org/10.1037/a0026838 .
doi: 10.1037/a0026838
Ten Cate O, Regehr G. The power of subjectivity in the assessment of medical trainees. Acad Med. 2019;94(3):333–7. https://doi.org/10.1097/acm.0000000000002495 .
doi: 10.1097/acm.0000000000002495
Abraham RM, Singaram VS. Using deliberate practice framework to assess the quality of feedback in undergraduate clinical skills training. BMC Med Educ. 2019;19:105. https://doi.org/10.1186/s12909-019-1547-5 .
doi: 10.1186/s12909-019-1547-5
Harrison CJ, Könings KD, Schuwirth L, Wass V, van der Vleuten C. Barriers to the uptake and use of feedback in the context of summative assessment. Adv Health Sci Educ. 2015;20:229–45. https://doi.org/10.1007/s10459-014-9524-6 .
doi: 10.1007/s10459-014-9524-6
Ramani S, Konings KD, Mann KV, Pisarski EE, van der Vleuten CPM. About politeness, face, and feedback: exploring resident and faculty perceptions of how institutional feedback culture influences feedback practices. Acad Med. 2018;93(9):1348–58.
doi: 10.1097/ACM.0000000000002193
Kluger AN, van Dijk D. Feedback, the various tasks of the doctor, and the feedforward alternative. Med Educ. 2010;44:1166–74.
doi: 10.1111/j.1365-2923.2010.03849.x
Bounds R, Bush C, Aghera A, Rodriguez N, Stansfield RB, Santeen SA. Emergency medicine residents’ self-assessments play a critical role when receiving feedback. Acad Emerg Med. 2013;20:1055–61. https://doi.org/10.1111/acem.12231 .
doi: 10.1111/acem.12231
O’Donovan B, Rust C, Price M. A scholarly approach to solving the feedback dilemma in practice. Assess Eval High Educ. 2016;41(6):938–49. https://doi.org/10.1080/02602938.2015.1052774 .
doi: 10.1080/02602938.2015.1052774
Boud D, Lawson R, Thompson D. The calibration of student judgement through self-assessment: disruptive effects of assessment patterns. High Educ Res Dev. 2015;34(1):45–59.
doi: 10.1080/07294360.2014.934328
Sadler DR. Beyond feedback: developing student capability in complex appraisal. Assess Eval High Educ. 2010;35:535–50. https://doi.org/10.1080/02602930903541015 .
doi: 10.1080/02602930903541015
Ericsson KA. An expert-performance perspective of research on medical expertise: the study of clinical performance. Med Educ. 2007;41:1124–30.
doi: 10.1111/j.1365-2923.2007.02946.x
Cramp A. Developing first-year engagement with written feedback. Act Learn High Educ. 2011;12:113–24. https://doi.org/10.1177/1469787411402484 .
doi: 10.1177/1469787411402484
Abraham RM, Singaram VS. Barriers and promoters in receptivity and utilization of feedback in a pre-clinical simulation based clinical training setting. Bangladesh J Med Sci. 2021;20(3):594–607. https://doi.org/10.3329/bjms.v20i3.52802 .
doi: 10.3329/bjms.v20i3.52802
Burke D. Strategies for using feedback students bring to higher education. Assess Eval High Educ. 2009;34:41–50.
doi: 10.1080/02602930801895711
Burch V, Seggie J, Gary N. Formative assessment promotes learning in undergraduate clinical clerkships. S Afr Med J. 2006;96:430–3.
Boileau É, Talbot-Lemaire M, Belanger M, St-Onge C. Playing in the big leagues now: exploring feedback receptivity during the transition to residency. Health Prof Educ. 2018;5(4). https://doi.org/10.1016/j.hpe.2018.09.003 .
Wertsch JV. Voices of the mind: a sociocultural approach to mediated action. Cambridge, MA: Harvard University Press; 1991.
Abraham RM. Balancing responsibility sharing in the simulated clinical skills setting: a strategy to remove barriers to feedback engagement as a new concept to promote a growth-enhancing feedback process. Afr J Health Prof Educ. 2023;15(1):2–6. https://doi.org/10.7196/AJHPE.2023.v15i1.1630 .
doi: 10.7196/AJHPE.2023.v15i1.1630