Designing feedback processes in the workplace-based learning of undergraduate health professions education: a scoping review

BACKGROUND

Feedback processes are crucial for learning, guiding improvement, and enhancing performance. In workplace-based learning settings, diverse teaching and assessment activities are advocated to be designed and implemented, generating feedback that students use, with proper guidance, to close the gap between current and desired performance levels. Since productive feedback processes rely on observed information regarding a student's performance, it is imperative to establish structured feedback activities within undergraduate workplace-based learning settings. However, these settings are characterized by their unpredictable nature, which can either promote learning or present challenges in offering structured learning opportunities for students. This scoping review maps literature on how feedback processes are organised in undergraduate clinical workplace-based learning settings, providing insight into the design and use of feedback.

METHODS

A scoping review was conducted. Studies were identified from seven databases and ten relevant journals in medical education. The screening process was performed independently in duplicate with the support of the StArt program. Data were organized in a data chart and analyzed using thematic analysis. The feedback loop with a sociocultural perspective was used as a theoretical framework.

RESULTS

The search yielded 4,877 papers, and 61 were included in the review. Two themes were identified in the qualitative analysis: (1) The organization of the feedback processes in workplace-based learning settings, and (2) Sociocultural factors influencing the organization of feedback processes. The literature describes multiple teaching and assessment activities that generate feedback information. Most papers described experiences and perceptions of diverse teaching and assessment feedback activities. Few studies described how feedback processes improve performance. Sociocultural factors such as establishing a feedback culture, enabling stable and trustworthy relationships, and enhancing student feedback agency are crucial for productive feedback processes.

CONCLUSIONS

This review identified concrete ideas regarding how feedback could be organized within the clinical workplace to promote feedback processes. The feedback encounter should be organized to allow follow-up of the feedback, i.e., working on required learning and performance goals at the next occasion. The educational programs should design feedback processes by appropriately planning subsequent tasks and activities. More insight is needed in designing a full-loop feedback process, in which specific attention is needed in effective feedforward practices.

Teaching evidence-based practice to undergraduate healthcare students Educators' knowledge, skills, attitudes, current practice, perceived barriers, and facilitators: A Danish cross-sectional study

BACKGROUND

Evidence-Based Practice is recognized as a standard practice and a core competence for clinical healthcare professionals and therefore educators' competences in teaching Evidence-Based Practice are essential. Yet only little is known about the knowledge, skills, attitudes, and teaching practices around Evidence-Based Practice among educators of Danish undergraduate healthcare students.

OBJECTIVES

The objectives of this study were to describe: 1) the Evidence-Based Practice profiles regarding attitudes, knowledge, skills, and teaching practices among educators who teach in undergraduate healthcare educations; 2) the current state of teaching Evidence-Based Practice in undergraduate program curricula; 3) the perceived barriers and facilitators to teach Evidence-Based Practice; and 4) the educators` needs regarding teaching Evidence-Based Practice.

DESIGN, SETTING AND PARTICIPANTS

A cross-sectional survey using a self-administrated online questionnaire among 81 educators at University College South Denmark.

METHODS

The survey covered 1) Demographic questions, 2) Educators Evidence-Based Practice profiles measured by the Evidence-Based Practice Questionnaire for teachers, 3) perceived state of Evidence-Based Practice teaching 4) perceived barriers and facilitators and 5) educators´ needs for competence development regarding teaching Evidence-Based Practice.

RESULTS

The translated version of the Evidence-Based Practice Questionnaire showed that respondents had a mean of 3,6 regarding practicing Evidence-Based Practice when asked to rank on a scale of 1-7 (higher score indicating higher degree). The respondents showed positive attitudes towards Evidence-Based Practice and had a high self-perception of their Evidence-Based Practice skills and knowledge, scoring an overall average value of 5 on these items. In open ended questions educators gave a variety of examples of their Evidence-Based Practice teaching in terms of content, teaching methods and cooperation with clinical practice.

CONCLUSIONS

Educators report limitations to teaching Evidence-Based Practice; however, attitudes, knowledge and skills were perceived generally high. Main facilitator was partnership with clinical practice and main barrier was time lack. MESH: Evidence-Based Practice, Health Educators, Knowledge, Attitude.