Clinical learning in the context of uncertainty: a multi-center survey of emergency department residents' and attending physicians' perceptions of clinical feedback

Feedback-based learning from viewpoints of surgical nursing students: A mixed-method study

BACKGROUND

Feedback-based learning (FBL) focuses on guiding the learning process according to educational objectives and the student's needs. This study aimed to investigate surgical nursing students' perceptions and explore their experiences of FBL.

METHOD

The present study used a mixed-methods sequential explanatory design that was conducted in the quantitative and qualitative phases. Surgical nursing students participated in the quantitative phase (n = 105). In the first phase, students completed two questionnaires about FBL and clinical feedback. Semi-structured face-to-face interviews were used to collect qualitative data in the second phase. Graneheim and Lundman's inductive approaches were used to analyse the qualitative data.

RESULTS

The mean (SD) score for students' perception of FBL was 3.99 ± 0.70. The qualitative results were explored in two themes, "motivational support for improvement" and "unpleasant learning".

CONCLUSION

In this study, the positive and negative aspects of FBL were explained. FBL is perceived as a motivational support mechanism to improve students' capabilities during their academic courses and also prepare them for future careers. Conversely, FBL may experience unpleasant learning due to negative feedback and negative emotions.

Application of combined teaching method of case-based-learning and clinical pathway in practical gynecological teaching

Background

To train highly qualified medical talent in 5-year programs and improve students' analytical and problem-solving abilities, it is necessary to change the traditional teaching method. This study introduces the combined teaching method of case-based learning (CBL) and clinical pathway and evaluates its role in practical gynecological teaching.

Methods

Medical students in a 5-year program who were enrolled in the fourth year were selected as the research subjects; these students were randomized into two groups that separately received either the traditional teaching method or the combined teaching method of CBL and clinical pathway. Before the internship, a questionnaire was administered to explore students' views of internship in gynecology, and after the internship, the questionnaire was administered to assess the two teaching methods. Furthermore, theoretical and skill tests were performed both before and after the internship.

Results

A total of 206 medical students in a 5-year program who were in their fourth year were enrolled in the study. Students in the experimental group performed significantly better than those in the control group. They performed significantly better in the postinternship test than in the preinternship test (P < 0.001). The questionnaire showed that more students in the experimental group thought that their learning interests, clinical skills, case analysis ability, clinical communication ability, understanding of theoretical knowledge and clinical thinking ability had improved and significantly differed between the two groups (P < 0.05).

Discussion

Compared to traditional teaching methods, combined teaching method of CBL and clinical pathway can elevate students' academic performance, improve their learning enthusiasm and help promote clinical teachers' teaching quality. Additionally, this novel method is effective in facilitating the achievement of teaching objectives and improving the quality of talent training. Therefore, the combined teaching method of CBL and clinical pathway should be popularized and applied in gynecological practice.

Feedback in Medical Education: An Evidence-based Guide to Best Practices from the Council of Residency Directors in Emergency Medicine

Within medical education, feedback is an invaluable tool to facilitate learning and growth throughout a physician's training and beyond. Despite the importance of feedback, variations in practice indicate the need for evidence-based guidelines to inform best practices. Additionally, time constraints, variable acuity, and workflow in the emergency department (ED) pose unique challenges to providing effective feedback. This paper outlines expert guidelines for feedback in the ED setting from members of the Council of Residency Directors in Emergency Medicine Best Practices Subcommittee, based on the best evidence available through a critical review of the literature. We provide guidance on the use of feedback in medical education, with a focus on instructor strategies for giving feedback and learner strategies for receiving feedback, and we offer suggestions for fostering a culture of feedback.

Junior doctor perceptions of education and feedback on ward rounds

AIM

The literature suggests that feedback is wanted and needed in clinical medicine and specifically on ward rounds, yet it is often lacking. This study aimed to examine junior doctor perceptions of education and feedback on ward rounds in one clinical department at a tertiary paediatric hospital and the key influences on these perceptions.

METHODS

Six semi-structured focus groups were conducted over a period of 9 months comprising of 20 participants (post-graduate year 1-5) in a general medical department of a tertiary paediatric hospital. Qualitative analysis was performed on focus group transcripts using an inductive approach and codes and themes were generated in an iterative fashion with checking of themes between two researchers.

RESULTS

Feedback experiences were largely positive compared to previous rotations. Three overarching themes were identified which influenced trainee perceptions of education and feedback on ward rounds. These were: consultant influences (e.g. educational engagement), trainee influences (e.g. active seeking of feedback), and structural factors (e.g. organisational constraints).

CONCLUSIONS

Despite positive feedback experiences, the need to improve feedback for our junior doctors is clear, but how to do this remains challenging when navigating work-learning tensions. The notion of the educational alliance between the consultant and trainee is a potential useful solution, but it requires deliberate effort and dedicated time to establish given our increasingly complex and busy clinical environments.

An educational intervention to increase student engagement in feedback

BACKGROUND

The learner has a central role in feedback. We developed a feedback workshop for medical students grounded in two concepts: (1) Student agency in feedback and its interplay in the context of brief clinical attachments; (2) The educational alliance.

AIMS

To determine whether a brief feedback training workshop prior to a series of two-week clinical attachments improves agentic student feedback behaviour (e.g. seeking, recognising, evaluating and utilising feedback) and student satisfaction with feedback.

METHODS

We conducted surveys among three consecutive student cohorts undertaking three fortnightly paediatric clinical attachments. We pilot tested a workshop with Cohort 1 and implemented it for the entire Cohorts 2 (n = 58) and 3 (n = 68). Participants completed the same survey at the start and end of term, with different free-text items. Quantitative and qualitative responses were compared between groups.

RESULTS

Student-reported agentic feedback behaviour increased across all outcomes except for feedback utilisation. Overall student satisfaction with feedback increased during the term in Cohorts 2 (23-65%, p = 0.002) and 3 (40-70%, p = 0.003) but not in Cohort 1 non-participating students (27-42%, p = 0.42).

CONCLUSIONS

A brief one-off student-directed feedback workshop may improve agentic student feedback behaviours (e.g. feedback-seeking) and student satisfaction with feedback.