Investigating conditions for meaningful feedback in the context of an evidence-based feedback programme.

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Title: Investigating conditions for meaningful feedback in the context of an evidence-based feedback programme.
Authors: Voyer, Stéphane, Cuncic, Cary, Butler, Deborah L, MacNeil, Kimberley, Watling, Christopher, Hatala, Rose
Source: Medical Education. Sep2016, Vol. 50 Issue 9, p943-954. 12p.
Subjects: Clinical medicine, Conceptual structures, Confidence, Education research, Experience, Focus groups, Goal (Psychology), Hospital medical staff, Internal medicine, Interviewing, Learning strategies, Research methodology, Case studies, Medical schools, Medical school faculty, Study & teaching of medicine, School environment, Students, Rating of students, Supervision of employees, Teacher-student relationships, Urban hospitals, Clinical competence, Qualitative research, Judgment sampling, Data analysis, Well-being, Educational attainment, Thematic analysis, Work experience (Employment), Field notes (Science), Education
Geographic Terms: British Columbia
Abstract: Context We developed, implemented and evaluated an evidence-based programme of feedback designed to address limitations identified in the current literature. Objectives We sought to advance understanding about how and why feedback processes might be more effective in clinical education. Methods Three faculty members and nine first-year internal medicine residents participated in the pilot programme. To counter challenges identified in the literature, feedback was based on direct observation, grounded in longitudinal faculty-resident relationships, and devoid of summative assessment. We used a qualitative case study design to address three research questions: (i) What benefits did the participants describe? (ii) What elements of the programme facilitated these benefits? (iii) What were the limitations and challenges of the programme? Collected data included audiotapes of interactions between faculty members and residents, field notes written during observations, and semi-structured interviews and focus groups with resident participants. Data analysis moved cyclically and iteratively through inductive and deductive analysis. Results Residents described benefits relating to their ways of working (clinical skills), ways of learning (accountability for learning) and ways of feeling (emotional well-being). According to participants, specific elements of the programme that achieved these benefits included the direct observation of authentic clinical work, the longitudinal relationship with a faculty member and the emergence of feedback as a conversation between the faculty member and learner. Conclusions We conclude that the conditions established within our pilot feedback programme influenced the learning culture for first-year internal medicine residents by grounding direct observation in authentic clinical work and setting the observations in the context of a longitudinal, non-assessment-based relationship between a faculty member and resident. These conditions appeared to influence residents' participation in the feedback process, their ways of approaching their daily clinical work, their emotional well-being and their engagement in their own learning. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: <searchLink fieldCode="DE" term="%22Clinical+medicine%22">Clinical medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Conceptual+structures%22">Conceptual structures</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence%22">Confidence</searchLink><br /><searchLink fieldCode="DE" term="%22Education+research%22">Education research</searchLink><br /><searchLink fieldCode="DE" term="%22Experience%22">Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Focus+groups%22">Focus groups</searchLink><br /><searchLink fieldCode="DE" term="%22Goal+%28Psychology%29%22">Goal (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+medical+staff%22">Hospital medical staff</searchLink><br /><searchLink fieldCode="DE" term="%22Internal+medicine%22">Internal medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Learning+strategies%22">Learning strategies</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Case+studies%22">Case studies</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+schools%22">Medical schools</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+school+faculty%22">Medical school faculty</searchLink><br /><searchLink fieldCode="DE" term="%22Study+%26+teaching+of+medicine%22">Study & teaching of medicine</searchLink><br /><searchLink fieldCode="DE" term="%22School+environment%22">School environment</searchLink><br /><searchLink fieldCode="DE" term="%22Students%22">Students</searchLink><br /><searchLink fieldCode="DE" term="%22Rating+of+students%22">Rating of students</searchLink><br /><searchLink fieldCode="DE" term="%22Supervision+of+employees%22">Supervision of employees</searchLink><br /><searchLink fieldCode="DE" term="%22Teacher-student+relationships%22">Teacher-student relationships</searchLink><br /><searchLink fieldCode="DE" term="%22Urban+hospitals%22">Urban hospitals</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+competence%22">Clinical competence</searchLink><br /><searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br /><searchLink fieldCode="DE" term="%22Judgment+sampling%22">Judgment sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis%22">Data analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Well-being%22">Well-being</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+attainment%22">Educational attainment</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Work+experience+%28Employment%29%22">Work experience (Employment)</searchLink><br /><searchLink fieldCode="DE" term="%22Field+notes+%28Science%29%22">Field notes (Science)</searchLink><br /><searchLink fieldCode="DE" term="%22Education%22">Education</searchLink>
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  Data: Context We developed, implemented and evaluated an evidence-based programme of feedback designed to address limitations identified in the current literature. Objectives We sought to advance understanding about how and why feedback processes might be more effective in clinical education. Methods Three faculty members and nine first-year internal medicine residents participated in the pilot programme. To counter challenges identified in the literature, feedback was based on direct observation, grounded in longitudinal faculty-resident relationships, and devoid of summative assessment. We used a qualitative case study design to address three research questions: (i) What benefits did the participants describe? (ii) What elements of the programme facilitated these benefits? (iii) What were the limitations and challenges of the programme? Collected data included audiotapes of interactions between faculty members and residents, field notes written during observations, and semi-structured interviews and focus groups with resident participants. Data analysis moved cyclically and iteratively through inductive and deductive analysis. Results Residents described benefits relating to their ways of working (clinical skills), ways of learning (accountability for learning) and ways of feeling (emotional well-being). According to participants, specific elements of the programme that achieved these benefits included the direct observation of authentic clinical work, the longitudinal relationship with a faculty member and the emergence of feedback as a conversation between the faculty member and learner. Conclusions We conclude that the conditions established within our pilot feedback programme influenced the learning culture for first-year internal medicine residents by grounding direct observation in authentic clinical work and setting the observations in the context of a longitudinal, non-assessment-based relationship between a faculty member and resident. These conditions appeared to influence residents' participation in the feedback process, their ways of approaching their daily clinical work, their emotional well-being and their engagement in their own learning. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/medu.13067
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        Text: English
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      – SubjectFull: Conceptual structures
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      – SubjectFull: Confidence
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      – SubjectFull: Education research
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      – SubjectFull: Internal medicine
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      – SubjectFull: Interviewing
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      – SubjectFull: Learning strategies
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