Can peer feedback substitute for faculty feedback in predoctoral dental education?

PURPOSE/OBJECTIVES

The ability to give and receive feedback is a key skill to develop during predoctoral dental education, and the use of peer feedback specifically offers distinct benefits including a different understanding of material due to peers' proximity of knowledge development and assisting with overburdened instructors. However, it is unclear if peer feedback offers similar quality to instructor feedback.

METHODS

Dental students in two different graduation years provided quantitative and qualitative peer feedback on a case-based oral and maxillofacial pathology simulation. The data from these exercises were aggregated and analyzed to compare the quality of qualitative feedback to course examination scores. Student perceptions of peer feedback were also recorded.

RESULTS

The mean quality of feedback was not correlated with course examination scores, though the number of times students gave high-quality feedback and received high-quality feedback was correlated with course examination scores. Student feedback overall had a lower quality than instructor feedback, though there was no significant difference between instructor feedback quality and the maximum student feedback quality received. Student perceptions of the utility of feedback were positive.

CONCLUSION

While instructor feedback is more reliable and consistent, our findings suggest that in most instances, at least one peer in moderate-sized groups is able to approximate the quality of instructor feedback on case-based assignments.

Peer assessment in medical communication skills training in programmatic assessment: A qualitative study examining faculty and student perceptions

INTRODUCTION

Current literature recommends assessment of communication skills in medical education combining different settings and multiple observers. There is still a gap in understanding about whether and how peers assessment facilitates learning in communication skills training.

METHODS

We designed a qualitative study using focus group interviews and thematic analysis, in a medical course in the Netherlands. We aimed to explore medical students' and teachers' experiences, perceptions, and perspectives about challenges and facilitating factors in PACST (Peer assessment in medical communication skills training).

RESULTS

Most of the participants reported that peer feedback was a valuable experience when learning communication skills. The major challenges for the quality and credibility of PACST reported by the participants are the question whether peer feedback is critical enough for learning and the difficulty of actually engaging students in the assessment process.

CONCLUSION

Teachers reviewing students' peer assessments may improve the quality and their credibility and the reviewed assessments can best be used for learning purposes. We suggest to pay sufficient attention to teachers' roles in PACST, ensuring a safe and trustworthy environment and additionally helping students to internalize the value of being vulnerable during the evaluation process.

Physical Effort Exertion for Peer Feedback Reveals Evolving Social Motivations From Adolescence to Young Adulthood

Peer relationships and social belonging are particularly important during adolescence. Using a willingness-to-work paradigm to quantify incentive motivation, we examined whether evaluative information holds unique value for adolescents. Participants (N = 102; 12-23 years old) rated peers, predicted how peers rated them, and exerted physical effort to view each peer's rating. We measured grip force, speed, and opt-out behavior to examine the motivational value of peer feedback, relative to money in a control condition, and to assess how peer desirability and participants' expectations modulated motivated effort across age. Overall, when compared with adolescents, adults were relatively less motivated for feedback than money. Whereas adults exerted less force and speed for feedback when expecting rejection, adolescents exerted greater force and speed when expecting to be more strongly liked or disliked. These findings suggest that the transition into adulthood is accompanied by a self-protective focus, whereas adolescents are motivated to consume highly informative feedback, even if negative.

Continuous idea contribution in open innovation communities: The role of verbal persuasion from peers

Motivating continuous idea contributions from members is especially challenging for open innovation communities (OIC). Scholars have thus explored a range of incentives, among which peer feedback has received much attention. However, existing research on peer feedback tends to focus on the structural features, ignoring the richness of the text. To fill this research gap, this study investigates the influence of feedback language use from peers, including emotional support and constructive feedback, on individuals' continuous idea contributions, based on the creative self-efficacy theory. The results show that emotional support, especially emotional approval, positively affects members' continuous contributions, and that the effect is stronger when the provider is of a higher status. However, individualized consideration does not seem to work. In addition, in terms of the effect of constructive feedback, we also find support from cognitive stimulation, while intellectual stimulation exerts an effect only when the provider's status is high. Overall, these findings extend the current research on peer feedback and offer practical guidelines to the open innovation community.

Ipsative Assessment and Peer Feedback in an Orthopaedic Junior Doctor Teaching Programme: A Project Plan and Narrative Review of the Literature

The main aim of this study is to describe a plan for a project to introduce the use of formative ipsative assessment and peer feedback within an orthopaedic junior doctor teaching programme. These changes will ensure that students demonstrate objective progress and understand that they are making progress in their learning journey. It will also improve learner collaboration through the creation of communities of practice. Key stakeholders involved include the junior doctors, tutors, consultants, medical education department, research/audit department, and orthopaedic company representatives. Outcomes will be measured using a four-point Likert scale on Google forms digital portfolios for the domains of clinical knowledge, technical skills, communication, teamwork, and basic research skills. Progress will be audited at six-month intervals. Full project implementation will be within 6-12 months. A narrative review of relevant literature and theories of learning in relation to ipsative assessment and peer feedback within a clinical teaching context was also performed.  The future of medical education will still contain large components of ipsative assessment. In addition, a problem-based collaborative learning approach is now utilized in many medical schools and peer feedback will become more frequently utilized as a part of this in future. The author looks forward to implementing this project successfully and anticipates that the knowledge/skills gained from this will be useful for any future career projects both within and outside medical education.

Design and Evaluation of the Veterinary Epidemiology Teaching Skills (VETS) Workshop: Building Capacity in the Asia-Pacific Region

Building workforce capacity in epidemiology skills for veterinarians in the Asia-Pacific region is crucial to health security. However, successful implementation of these programs requires a supply of trained veterinary epidemiology teachers and mentors. We sought to design and evaluate delivery of a 4-day Veterinary Epidemiology Teaching Skills (VETS) workshop as part of a larger project to strengthen field veterinary epidemiology capacity. Thirty-five veterinarians were selected to participate in the 4-day VETS workshop, consisting of nine modules delivered synchronously online. Participants were formatively assessed and given feedback from peers and facilitators on all activities. Data were collected with pre- and post-course questionnaires. Numeric values were categorized to convert into an ordinal scale with four categories. Qualitative data were analyzed using thematic analysis. Thirty-four veterinary epidemiologists from eight countries of the Asia-Pacific completed the workshop. Participants felt able to achieve most key learning outcomes through provision of succinct literature, teaching frameworks, and active participation in small groups, with multiple opportunities to give and receive feedback. Although the online workshop provided flexibility, participants felt the addition of face-to-face sessions would enrich their experience. Additionally, protected time from work duties would have improved their ability to fully engage in the workshop. The VETS workshop granted an effective online framework for veterinary epidemiologists to develop and practice skills in teaching, facilitation, assessment, feedback, case-based learning, program evaluation, and mentorship. A challenge will be ensuring provision of local teaching and mentoring opportunities to reinforce learning outcomes and build workforce capacity.

Assessment of Virtual Peer Learning by Peer Feedback: A Pilot Project

Introduction Virtual learning has become the preferred modality for health education during and after the coronavirus disease 2019 (COVID-19) pandemic. Peer learning is gaining a lot of significance lately and has been successfully tested in various settings. We combined virtual delivery of health education with peer-assisted learning and evaluated the effectiveness using peer-generated feedback and tested the effectiveness of the model for different cohorts. Methods We performed this study as part of a formal educational course on Health Professions Education. The educators were volunteers from different informal multi-disciplinary groups, working in varied healthcare settings, globally. This involved eight teaching sessions which were delivered virtually and the feedback was recorded as responses to six items (questions), which the learners graded on the Likert scale. The average for each item and the larger domains was then calculated and analyzed.  Results The feedback was provided by all the participants (53/53). In the feedback received item-wise, the best average rating was for legibility of the slides (4.8). The least rating was for adequate checking and assessment of prior knowledge (4.2). In terms of the broader domains, the best feedback was for the teaching material (4.6) and the lowest was for the planning of the sessions (4.4). Overall, the ratings for the domains and the items were above 3 on a scale of 1-5. Conclusions Virtual delivery of healthcare education, facilitated by peer-assisted learning, is an effective model for health education when delivered for a small group, as evidenced by the overall peer feedback. This model can be tested for larger cohorts in the future.

Learners' perceived advantages and social-affective dispositions toward online peer feedback in academic writing

Peer feedback is widely acknowledged for its advantages and benefits in improving students' learning in writing classes. Although the integration of online platforms has been found to impact peer feedback, research on second language learners' perceived advantages of social affective disposition to using multiple platforms for delivering peer feedback is limited. To address the aforementioned research gap, we conducted this 12-week action research to explore how 12 doctoral students at a university in Macau perceived their experience of using multiple online feedbacks in an academic writing course. To integrate the various advantages of different online platforms, we adopted three tools including Moodle, Rain Classroom, and WeChat for the delivery of peer feedback. The results demonstrated learners' perceived advantages and disadvantages of online peer feedback and how the different online peer feedback can be combined to magnify their benefits for academic writing. It also revealed that the use of emojis, memes, and one-to-one conversation window on WeChat can foster students' positive emotions. However, the ubiquitous connection by WeChat Moments increased their emotional load and undermined peer trust.

A Team-Based Activity to Support Knowledge Transfer and Experimental Design Skills of Undergraduate Science Students

Experimental design may be considered an essential learning objective of undergraduate science education. This skill not only requires learners to be able to identify novel questions, generate hypotheses, create experimental models, and anticipate data outcomes but also demands that students are able to effectively transfer and apply knowledge from previous learning experiences to novel contexts. Here, I describe a team-based activity for upper-level undergraduate science courses that aims to strengthen students' skills in experimental design and transfer of knowledge. Instructional resources are provided to facilitate straightforward application in courses of diverse science disciplines and delivery modes.

Assessment of a Large-Scale Peer Learning Program's Value by Manual Review of Case Submissions

OBJECTIVE

Prior studies used submission numbers or report addendum rates to measure peer learning programs' (PLP) impact. We assessed the educational value of a PLP by manually reviewing cases submitted to identify factors correlating with meaningful learning opportunities (MLOs).

METHODS

This institutional review board-exempted, retrospective study was performed in a large academic radiology department generating >800,000 reports annually. A PLP facilitating radiologist-to-radiologist feedback was implemented May 1, 2017, with subsequent pay-for-performance initiatives encouraging increasing submissions, >18,000 by 2019. Two radiologists blinded to submitter and receiver identity categorized 336 randomly selected submissions as a MLO, not meaningful, or equivocal, resolving disagreements in consensus review. Primary outcome was proportion of MLOs. Secondary outcomes included percent engagement by subspecialty clinical division and comparing MLO and report addendum rates via Fisher's exact tests. We assessed association between peer learning category, pay-for-performance interventions, and subspecialty division with MLOs using logistic regression.

RESULTS

Of 336 PLP submissions, 65.2% (219 of 336) were categorized as meaningful, 27.4% (92 of 336) not meaningful, and 7.4% (25 of 336) equivocal, with substantial reviewer agreement (86.0% [289 of 336], κ = 0.71, 95% confidence interval 0.64-0.78). MLO rate (65.2% [219 of 336]) was five times higher than addendum rate (12.9% [43 of 333]) for the cohort. MLO proportion (adjusted odds ratios 0.05-1.09) and percent engagement (0.5%-3.6%) varied between subspecialty divisions, some submitting significantly fewer MLOs (P < .01). MLO proportion did not vary between peer learning categories.

CONCLUSION

Educational value of a large-scale PLP, estimated through manual review of case submissions, is likely a more accurate measure of program impact. Incentives to enhance PLP use did not diminish the program's educational value.

Fostering Self-Regulated Learning in Online Environments: Positive Effects of a Web-Based Training With Peer Feedback on Learning Behavior

Although training in self-regulated learning (SRL) is effective in improving performance, human trainers can reach only a few people at a time. We developed a web-based training for potentially unlimited numbers of participants based on the process model of SRL by Schmitz and Wiese (2006). A prior study (Bellhäuser et al., 2016) observed positive effects on self-reported SRL and self-efficacy. In the present randomized controlled trial, we investigated an improved version of the web-based training, augmented by the application of peer feedback groups. Prospective university students in an online mathematics preparation course were assigned randomly to one of four experimental conditions: Group D (diary), group TD (training + diary), group TDP (training + diary + peer feedback group), and group C (control). Complete data was obtained for 136 participants (78.8% male; M = 19.8 years). The learning diary was intended to trigger goal setting, planning, and self-motivation in the morning and reflection in the evening. The web-based training consisted of three lessons (approximately 90 min each) with videos, presentations, self-tests, and exercises. In the peer feedback condition, participants were randomly assigned to groups of five persons each and used a bulletin board to discuss pre-defined topics related to the content of the web-based training. Outcome measures included a test of declarative SRL knowledge, an SRL questionnaire, a general self-efficacy scale, log file data, and a mathematics test. Results showed positive effects for the web-based training, particularly when combined with peer feedback on both SRL knowledge and SRL questionnaires, self-efficacy, and on objective time-investment, but not on the mathematics test. The learning diary did not exhibit positive effects. We conclude that additional peer-feedback seems to be a useful supplement to web-based trainings with comparably low organizational costs.

Self-Regulated Writing Strategy Use When Revising Upon Automated, Peer, and Teacher Feedback in an Online English as a Foreign Language Writing Course

Research investigating the intricacies of how self-regulated writing strategies are used in a finely focused area of the second language (L2) writing process is still lacking. This study takes a mixed-methods approach to explore Chinese English as a Foreign Language (EFL) learners' use of self-regulated writing strategies when revising based on automated, peer, and teacher feedback in an online EFL writing context. Thirty-six Chinese university learners filled in three questionnaires (one per feedback source). In addition, four learners followed a think-aloud protocol while revising and responding to a stimulated recall interview to provide further data. The results revealed that learners employed an array of self-regulated writing strategies to attain their feedback revision goals. Learners used more cognitive strategies when revising based on automated feedback compared with peer and teacher feedback and more motivational strategies when revising based on teacher feedback. The think-aloud data and stimulated recall interviews coincided with the quantitative findings. Textual analysis revealed that feedback type and quantity were associated with self-regulated writing strategy use.

A video- and feedback-based approach to teaching communication skills in undergraduate clinical dental education: The student perspective

OBJECTIVE

Student evaluation of a communication-education programme that combined patient consultation videos with peer- or expert-based feedback.

METHODS

A self-perception questionnaire was given to undergraduate dental students who had undertaken a curricular communication training and feedback programme, in which each participant was videoed three times during a patient interview or consultation, subsequently receiving either peer (PG) or expert feedback (EG). The questionnaire used feedback programme content to evaluate student perspectives, ascertaining whether the students experienced a gain in knowledge and professional conversational skills, whether videos or feedback helped them improve more and general questions about the structure and content of the curriculum. Differences between feedback groups were analysed (Mann-Whitney U test).

RESULTS

45 participants (peer group: n = 23, expert group: n = 22) took part in the study. The peer group experienced watching their video (38%) and receiving feedback (33%) as their major beneficial aspect to improve communication skills (watching fellow student´s video: 17%, providing feedback: 12%). The expert group experienced the major effect in receiving expert feedback (73%, video watching: 27%). The students said that communication skills should be a core competency in dental education learning outcomes (PG: 4.48 ± 0.67, EG: 4.41 ± 0.67; P > 0.05) and that communication curricula should include video-based feedback (PG: 3.91 ± 0.73, EG: 4.00 ± 0.93; P > 0.05).

CONCLUSION

Watching videos and both receiving and providing peer group feedback were experienced as helpful in improving students' communication skills. These findings suggest that a longitudinal communication curriculum, which includes both video-based peer feedback and correlated self-reflection, is a promising learning approach for dental education.

Effects of Trained Peer vs. Teacher Feedback on EFL Students' Writing Performance, Self-Efficacy, and Internalization of Motivation

This study investigated the longer-term impacts (i.e., into the next semester) of trained peer feedback in comparison with teacher feedback on students' writing development and writing motivation. Sections of an EFL writing course were randomly assigned to either teacher feedback or trained peer feedback conditions across two semesters. In the first semester, during their writing class, students either received training in how to implement peer feedback or simply studied models of writing (that were also used in the training work). In the second semester, students either received teacher or peer feedback across multiple assignments. Writing competence, writing self-efficacy, and writing self-regulated learning were assessed at the beginning and end of the second semester. Trained peer feedback and teacher feedback had similar positive effects on the improvement of writing competence and writing self-efficacy. However, trained peer feedback led to a significant enhancement of students' autonomous motivation relative to no such growth from teacher feedback.

Evaluating the SPIKES Model for Improving Peer-to-Peer Feedback Among Internal Medicine Residents: a Randomized Controlled Trial

BACKGROUND

Feedback improves trainee clinical performance, but the optimal way to provide it remains unclear. Peer feedback offers unique advantages but comes with significant challenges including a lack of rigorously studied methods. The SPIKES framework is a communication tool adapted from the oncology and palliative care literature for teaching trainees how to lead difficult conversations.

OBJECTIVE

To determine if a brief educational intervention focused on the SPIKES framework improves peer feedback between internal medicine trainees on inpatient medicine services as compared to usual practice.

DESIGN

Randomized, controlled trial at an academic medical center during academic year 2017-2018.

PARTICIPANTS

Seventy-five PGY1 and 49 PGY2 internal medicine trainees were enrolled. PGY2s were randomized 1:1 to the intervention or control group.

INTERVENTION

The intervention entailed a 30-min, case-based didactic on the SPIKES framework followed by a refresher email on SPIKES sent to PGY2s before each inpatient medicine rotation. PGY1s were blinded as to which PGY2s underwent the training.

MAIN MEASURES

The primary outcome was PGY1 evaluation of the extent of feedback provided by PGY2s. Secondary outcomes included PGY1 report of feedback quality and PGY2 self-report of feedback quantity and quality. Outcomes were obtained via anonymous online survey and reported using a Likert scale with a range of one to four.

KEY RESULTS

PGY1s completed 207 surveys (51% response rate) and PGY2s completed 61 surveys (42% response rate). PGY1s reported a higher extent of feedback (2.5 vs 2.2; p = 0.02; Cohen's d = 0.31), more specific feedback (2.3 vs 2.0; p < 0.01; d = 0.33), and higher satisfaction with feedback (2.6 vs 2.2; p < 0.01; d = 0.47) from intervention PGY2s. There were no significant differences in PGY2 self-reported outcomes.

CONCLUSIONS

With modest implementation requirements and notable limitations, a brief educational intervention focused on SPIKES increased PGY1 perception of the extent, specificity, and satisfaction with feedback from PGY2s.

Understanding the Difference Between Self-Feedback and Peer Feedback: A Comparative Study of Their Effects on Undergraduate Students' Writing Improvement

Due to the growing popularity of Assessment for Learning in higher education, self- feedback and peer feedback are often highlighted for their role in improving writing performance. In order to provide appropriate support for students' effective implementation of the feedback, teachers must comprehend the differential characteristics of self- and peer feedback. However, empirical research comparing the two remains scarce, particularly when they are used in combination. In this study, 116 Hong Kong undergraduate students participated in an abstract writing task and engaged in self- and peer feedback processes. The amount, types, and implementation of self- and peer feedback and their effects on writing improvement were analyzed and compared. Hierarchical regression analyses indicated that about 25% of the variance in the students' writing improvement was collectively accounted for by the two feedback processes. One form of feedback contributed about 15% of the variance while the other form explained 10%. Feedback types and the amount of implemented feedback were found to be positive predictors of writing improvement, whereas the overall feedback amount negatively affected the improvement. Moreover, the implementation of peer feedback was found to have a greater effect on the improvement than those of self-feedback. Several pedagogical implications of these findings are addressed.

Peer Feedback in Translation Training: A Quasi-Experiment in an Advanced Chinese-English Translation Course

Although research on peer feedback in second language teaching and learning has been developed from various perspectives over the past three decades, less is known about feedback in translation settings. This study reports the results of a quasi-experiment with advanced second language learners in a Chinese–English translation course. It examines how effective peer feedback is in improving the quality of translations. The following data were collected from 30 students: their initial translation drafts, the drafts with the feedback of their peers, and the final corrected translations. The whole process was facilitated by computer assistance and under anonymity. It was found that most students drew on direct or indirect corrective feedback while few students drew on metalinguistic corrective feedback. Text genres were also proved to impact the types and counts of peer feedback. An analysis of the accuracy rate of corrections after peer feedback showed that it had a positive impact on translation quality. The findings shed light on the applicability of peer feedback in other pedagogical activities.

The effect of peer modelling and discussing modelled feedback principles on medical students' feedback skills: a quasi-experimental study

BACKGROUND

Teaching is an important professional skill for physicians and providing feedback is an important part of teaching. Medical students can practice their feedback skills by giving each other peer feedback. Therefore, we developed a peer feedback training in which students observed a peer that modelled the use of good feedback principles. Students then elaborated on the modelled feedback principles through peer discussion. This combination of peer modelling and discussing the modelled feedback principles was expected to enhance emulation of the feedback principles compared to (1) only peer modelling and (2) discussing the feedback principles without previous modelling.

METHODS

In a quasi-experimental study design, 141 medical students were assigned randomly to three training conditions: peer modelling plus discussion (MD), non-peer modelled example (NM) or peer modelling without discussion (M). Before and after the training, they commented on papers written by peers. These comments served as a pre- and a post-measure of peer feedback. The comments were coded into different functions and aspects of the peer feedback. Non-parametrical Kruskall-Wallis tests were used to check for pre- and post-measure between-group differences in the functions and aspects.

RESULTS

Before the training, there were no significant between-group differences in feedback functions and aspects. After the training, the MD-condition gave significantly more positive peer feedback than the NM-condition. However, no other functions or aspects were significantly different between the three conditions, mainly because the within-group interquartile ranges were large.

CONCLUSIONS

The large interquartile ranges suggest that students differed substantially in the effort placed into giving peer feedback. Therefore, additional incentives may be needed to motivate students to give good feedback. Teachers could emphasise the utility value of peer feedback as an important professional skill and the importance of academic altruism and professional accountability in the peer feedback process. Such incentives may convince more students to put more effort into giving peer feedback.

Peer Learning in Radiology: Effect of a Pay-for-Performance Initiative on Clinical Impact and Usage

OBJECTIVE. The purpose of this article is to assess the effects of a pay-for-performance (PFP) initiative on clinical impact and usage of a radiology peer learning tool. MATERIALS AND METHODS. This retrospective study was performed at a large academic hospital. On May 1, 2017, a peer learning tool was implemented to facilitate radiologist peer feedback including clinical follow-up, positive feedback, and consultation. Subsequently, PFP target numbers for peer learning tool alerts by subspecialty divisions (October 1, 2017) and individual radiologists (October 1, 2018) were set. The primary outcome was report addendum rate (percent of clinical follow-up alerts with addenda), which was a proxy for peer learning tool clinical impact. Secondary outcomes were peer learning tool usage rate (number of peer learning tool alerts per 1000 radiology reports) and proportion of clinical follow-up alerts (percent of clinical follow-ups among all peer learning tool alerts). Outcomes were assessed biweekly using ANOVA and statistical process control analyses. RESULTS. Among 1,265,839 radiology reports from May 1, 2017, to September 29, 2019, a total of 20,902 peer learning tool alerts were generated. The clinical follow-up alert addendum rate was not significantly different between the period before the PFP initiative (9.9%) and the periods including division-wide (8.3%) and individual (7.9%) PFP initiatives (p = .55; ANOVA). Peer learning tool usage increased from 2.2 alerts per 1000 reports before the PFP initiative to 12.6 per 1000 during the division-wide PFP period (5.7-fold increase; 12.6/2.2), to 25.2 in the individual PFP period (11.5-fold increase vs before PFP; twofold increase vs division-wide) (p < .001). The clinical follow-up alert proportion decreased from 37.5% before the PFP initiative, to 34.4% in the division-wide period, to 31.3% in the individual PFP period. CONCLUSION. A PFP initiative improved radiologist engagement in peer learning by marked increase in peer learning tool usage rate without a change in report addendum rate as a proxy for clinical impact.

Tracing the Path Toward Self-Regulated Revision: An Interplay of Instructor Feedback, Peer Feedback, and Revision Goals

Building upon Zimmerman’s socio-cognitive view of self-regulation, we explored EFL (English as a Foreign Language) students’ revision and the likely contribution to revision from three salient self-regulating sources: peer feedback, instructor feedback, and revision goals. Data was obtained from 70 Chinese EFL students in a writing class through a 300-word online writing assignment involving online instructor and peer feedback, free-response revision goals, and a required revision. We closely coded students’ revision and then used the same coding scheme to analyze the relative levels of association of revision changes with peer comments, instructor comments and revision goals. We found that: (a) the majority of revision changes have been triggered by three mediating sources, with revision goals as the most significant contributing source. Additionally, most revision changes come from a combination of two or three sources, with the overlap of peer feedback and revision goals accounting for the biggest overlapping contribution for both high and low-level revisions; (b) as for the relationship among the three sources, no significant difference was found between revision goals’ overlap rate with peer feedback and their overlap rate with instructor feedback. Instructor feedback and peer feedback did not overlap very much. Findings suggest that students could revise beyond instructor and peer feedback in their revision efforts guided by their own reflective goals, and peer feedback could function as a more productive and multiple-reader source of revision in comparison with instructor feedback. This study also provided evidence for students’ self-regulated learning of writing through the use of self-regulating resources and charted a route for how writing could be improved.

Using Peer Feedback to Promote Clinical Excellence in Hospital Medicine

Hospitalists provide a significant amount of direct clinical care in both academic and community hospitals. Peer feedback is a potentially underutilized and low resource method for improving clinical performance, which lends itself well to the frequent patient care handoffs that occur in the practice of hospital medicine. We review current literature on peer feedback to provide an overview of this performance improvement tool, briefly describe its incorporation into multi-source clinical performance appraisals across disciplines, highlight how peer feedback is currently used in hospital medicine, and present practical steps for hospital medicine programs to implement peer feedback to foster clinical excellence among their clinicians.

Best Practices in Peer Assessment: Training Tomorrow's Physicians to Obtain and Provide Quality Feedback

Peer assessment, also known as peer feedback or peer evaluation, is a tool used in medical education for students to provide and receive constructive feedback. In undergraduate medical education, peer feedback is a method of assessment that is not used commonly; however, its use is on the rise. In this literature-based guide, we discuss the advantages of peer assessment, as well as tips for implementation (including training of students and faculty and assessment tools/instruments) and strategies to overcome barriers to its use. Effective utilization of peer feedback can provide educators with an opportunity to evaluate attributes that are often difficult to assess, including professionalism, teamwork, work habits, and communication skills. Constructive feedback can raise learner awareness about performance and guide future decisions and action plans for improvement. Overall, when used appropriately, peer feedback can be a valuable and effective addition to the arsenal of assessments in medical education.

Implementation of online peer feedback for student self-reflection - first steps on the development of a feedback culture at a medical faculty

Objective: Acquisition and application of professional and personal competences is accompanied by the formation and consolidation of attitudes and values and is influenced by the norms and moods (trust and feedback culture) experienced in the learning environment in question [1]. In particular, feedback and peer feedback can have a positive influence on the learning progress and personal development of students [2], [3], [4]. The promotion of a culture of teaching and ultimately of trust or feedback, plays a special role in this [5]. The aim was therefore to structurally integrate feedback into the curriculum of a model study course in order to develop a feedback culture in which students can develop personally and professionally with the help of regular and constructive feedback. Methodology: Following an initial pilot phase in 2009, (peer) feedback was gradually integrated into the curriculum at the medical faculty, in the first instance through checklists and subsequently through an online questionnaire and direct interviews. The activities were regularly analyzed on the basis of student evaluations using the EvaSys evaluation software and semi-standardized questionnaire-based interviews with six students in 2009 and 13 students each in 2012 and 2013. Results: Initially, students felt that the trust and feedback culture at their location as being in need of improvement. There were uncertainties regarding the use of constructive feedback and making criticism but also trust issues regarding the expression of personal perceptions to faculty members. It was possible to document the increase in the acceptance of the offers in the course of their establishment by an improvement in student evaluation and an increase in the number of participants in the voluntary offers amongst others. Qualitative data showed that students had a more positive perception or assessment of the location's feedback concept as well as indications of improvements in the culture of trust at the location. The proportion of constructive free-text comments increased significantly by 11% to 99.4% compared to the previous year (t(3)=-3.79, p=0.04). Thus, in terms of the objective, an increase in feedback activities and their quality at the faculty was achieved. Conclusion: Feedback, its acceptance as well as the quality, can be positively influenced at a faculty. Change measures should be tested repeatedly in discussion with users regarding practicability in order to directly pick up implementation issues and obstacles so they can be remedied in the interests of the users. This can influence the development of a culture of trust and feedback and should promote the personal and professional development of students in the long term.

Heritability of aggression following social evaluation in middle childhood: An fMRI study

Middle childhood marks an important phase for developing and maintaining social relations. At the same time, this phase is marked by a gap in our knowledge of the genetic and environmental influences on brain responses to social feedback and their relation to behavioral aggression. In a large developmental twin sample (509 7‐ to 9‐year‐olds), the heritability and neural underpinnings of behavioral aggression following social evaluation were investigated, using the Social Network Aggression Task (SNAT). Participants viewed pictures of peers that gave positive, neutral, or negative feedback to the participant's profile. Next, participants could blast a loud noise toward the peer as an index of aggression. Genetic modeling revealed that aggression following negative feedback was influenced by both genetics and environmental (shared as well as unique environment). On a neural level (n = 385), the anterior insula and anterior cingulate cortex gyrus (ACCg) responded to both positive and negative feedback, suggesting they signal for social salience cues. The medial prefrontal cortex (mPFC) and inferior frontal gyrus (IFG) were specifically activated during negative feedback, whereas positive feedback resulted in increased activation in caudate, supplementary motor cortex (SMA), and dorsolateral prefrontal cortex (DLPFC). Decreased SMA and DLPFC activation during negative feedback was associated with more aggressive behavior after negative feedback. Moreover, genetic modeling showed that 13%–14% of the variance in dorsolateral PFC activity was explained by genetics. Our results suggest that the processing of social feedback is partly explained by genetic factors, whereas shared environmental influences play a role in behavioral aggression following feedback.

Self-Observation and Peer Feedback as a Faculty Development Approach for Problem-Based Learning Tutors: A Program Evaluation

PROBLEM

Good teaching requires spontaneous, immediate, and appropriate action in response to various situations. It is even more crucial in problem-based learning (PBL) tutorials, as the tutors, while directing students toward the identification and attainment of learning objectives, must stimulate them to contribute to the process and provide them with constructive feedback. PBL tutors in medicine lack opportunities to receive feedback from their peers on their teaching strategies. Moreover, as tutorials provide little or no time to stop and think, more could be learned by reflecting on the experience than from the experience itself. We designed and evaluated a faculty development approach to developing PBL tutors that combined self-reflection and peer feedback processes, both powerful techniques for improving performance in education.

INTERVENTION

We developed an observation instrument for PBL facilitation to be used both by tutors to self-observe and reflect on own teaching strategies and by peers to observe and provide feedback to tutors. Twenty PBL sessions were video-recorded. Tutors completed the instrument immediately after their PBL session and again while watching their video-recorded session (self-observation). A group of three observers completed the instrument while watching each recorded session and provided feedback to each tutor (peer observation and feedback). We investigated tutors' perceptions of the feasibility and acceptability of the approach and gathered data on its effectiveness in enhancing tutors' facilitation skills.

CONTEXT

The preclinical medical curriculum at the University of Geneva is essentially taught by PBL. A new program of faculty development based on self-observation and peer feedback was offered to voluntary tutors and evaluated.

OUTCOME

Our results suggest that self-observation and peer feedback, supported by an instrument, can be effective in enhancing tutors' facilitation skills. Reflection on self-observation raised teachers' awareness of the effectiveness of the strategies they used to foster student learning. This motivated a need to change their teaching practice. However, for the changes to become operative, peer feedback was required, providing the cues and strategies needed to improve the facilitation skills.

LESSONS LEARNED

Peer coaching was considered feasible and useful to improve tutors' facilitation skills. Evaluating the program made it possible to assess tutors' needs and the reasons underlying their difficulties, and this in turn provided the basis for advanced workshops. Nonetheless, aspects related to logistics and the time constraints of such an individualized approach, as well as the cultural appropriation of peer coaching, might be obstacles that need to be addressed.

The Effects of Writing Anxiety and Motivation on EFL College Students' Self-Evaluative Judgments of Corrective Feedback

Feedback is regarded as a way to foster students' motivation and to ensure linguistic accuracy. However, mixed findings are reported in the research on written corrective feedback because of its multifaceted nature and its correlations with learners' individual differences. It is necessary, therefore, to conduct further research on corrective feedback from the student's perspective and to examine how individual differences in terms of factors such as writing anxiety and motivation predict learners' self-evaluative judgments of both teacher-corrected and peer-corrected feedback. For this study, 158 Taiwanese college sophomores participated in a survey that comprised three questionnaires. Results demonstrated that intrinsic motivation and different types of writing anxiety predicted English as foreign language learners' evaluative judgments of teacher and peer feedback. The findings have implications for English-writing instruction.

Analysis of dental students' written peer feedback from a prospective peer assessment protocol

INTRODUCTION

Peer assessment and feedback is encouraged to enhance students' learning. The aim of this study was to quantitatively and qualitatively analyse pre-clinical and clinical dental students' written peer feedback provided as part of a continuous, formative and structured peer assessment protocol.

MATERIALS AND METHODS

A total of 309 Year-2 and Year-5 dental students were invited to participate in a peer assessment and peer feedback protocol. Consenting volunteer students were trained to observe each other whilst working in the skills laboratory (Year-2) and in the dental clinic (Year-5). Subsequently, they followed a structured protocol of peer assessment and peer feedback using specially designed work-based forms during a complete academic year. The content of their written feedback was coded according to the UK General Dental Council domain, sign (positive or negative), specificity (task specific or general), and grouped into themes.

RESULTS

A total of 108 participants (40 Year-2 and 68 Year-5) completed 1169 peer assessment work-based forms (516 pre-clinical and 653 clinical); 94% contained written feedback. The large majority (82%) of Year-2 feedback represented the clinical domain, 89% were positive, 77% were task specific, and they were grouped into 14 themes. Year-5 feedback was related mostly to Management and Leadership (37%) and Communication (32%), 64% were positive, 75% task specific, and they were clustered into 24 themes.

DISCUSSION

The content of the feedback showed notable differences between Year-2 and Year-5 students. Senior students focused more on Communication and Management and Leadership skills, whilst juniors were more concerned with clinical skills. Year-5 students provided 13% negative feedback compared to only 2% from Year-2. Regulatory focus theory is discussed to explain these differences. Both groups provided peer feedback on a wide and different range of themes. However, four themes emerged in both groups: efficiency, infection control, time management and working speed.

CONCLUSION

A structured peer assessment framework can be used to guide pre-clinical and clinical students to provide peer feedback focused on different domains, and on contrasting signs and specificities. It can also present an opportunity to complement tutors' feedback.

Near-peer role modeling: Can fourth-year medical students, recognized for their humanism, enhance reflection among second-year students in a physical diagnosis course?

INTRODUCTION

Humanism is cultivated through reflection and self-awareness. We aimed to employ fourth-year medical students, recognized for their humanism, to facilitate reflective sessions for second-year medical students with the intention of positively influencing reflective process toward humanistic development.

METHODS/ANALYSIS

A total of 186 students were randomly assigned to one of three comparison arms: eight groups of eight students (64 students) were facilitated by a fourth-year student who was a Gold Humanism Honor Society member (GHHS); eight groups (64 students) by a volunteer non-GHHS student; and seven groups (58 students) were non-facilitated. Before sessions, second-year students set learning goals concerning interactions with patients; fourth-year students received training materials on facilitation. Groups met twice during their 10 clinical site visits. At the last session, students completed a reflective assignment on their goal progress. Comparative mixed method analyses were conducted among the three comparison arms on reflection (reflective score on in-session assignment) and session satisfaction (survey) in addition to a thematic analysis of responses on the in-session assignment.

RESULTS

We found significant differences among all three comparison arms on students' reflective scores (p=0.0003) and satisfaction (p=0.0001). T-tests comparing GHHS- and non-GHHS-facilitated groups showed significantly higher mean reflective scores for GHHS-facilitated groups (p=0.033); there were no differences on session satisfaction. Thematic analysis of students' reflections showed attempts at self-examination, but lacked depth in addressing emotions. There was a common focus on achieving comfort and confidence in clinical skills performance.

DISCUSSION/CONCLUSIONS

Near peers, recognized for their humanism, demonstrated significant influence in deepening medical students' reflections surrounding patient interactions or humanistic development. Overall, students preferred facilitated to non-facilitated peer feedback forums. This model holds promise for enhancing self-reflection in medical education, but needs further exploration to determine behavioral effects.

Dental students' peer assessment: a prospective pilot study

INTRODUCTION

Peer assessment is increasingly used in health education. The aims of this study were to evaluate the reliability, accuracy, educational impact and student's perceptions of undergraduate pre-clinical and clinical dental students' structured and prospective Peer assessment and peer feedback protocol.

MATERIALS AND METHODS

Two Direct Observation of Procedural Skills (DOPS) forms were modified for use in pre-clinical and clinical peer assessment. Ten year two dental students working in a phantom-heads skills laboratory and 16-year five dental students attending a comprehensive care clinic piloted both peer DOPS forms. After training, pairs of students observed, assessed and provided immediate feedback to each other using their respective peer DOPS forms as frameworks. At the end of the 3-month study period, students anonymously provided their perceptions of the protocol.

RESULTS

Year 2 and year 5 students completed 57 and 104 peer DOPS forms, respectively. The generalizability coefficient was 0.62 for year 2 (six encounters) and 0.67 for year 5 (seven encounters). Both groups were able to differentiate amongst peer-assessed domains and so detect improvement in peers' performance over time. Peer DOPS scores of both groups showed a positive correlation with their mean end-of-year examination marks (r ≥ 0.505, P ≥ 0.051) although this was not statistically significant. There was no difference (P ≥ 0.094) between the end-of-year examination marks of the participating students and the rest of their respective classes. The vast majority of both groups expressed positive perceptions of the piloted protocol.

DISCUSSION

There are no data in the literature on the prospective use of peer assessment in the dental undergraduate setting. In the current study, both pre-clinical and clinical students demonstrated the ability to identify those domains where peers performed better, as well as those which needed improvement. Despite no observable educational impact, most students reported positive perceptions of the peer DOPS protocol.

CONCLUSIONS

The results of this pilot study support the need for and the potential benefit of a larger- and longer-term follow-up study utilising the protocol.

Why peer assessment helps to improve clinical performance in undergraduate physical therapy education: a mixed methods design

BACKGROUND

Peer Assessment (PA) in health professions education encourages students to develop a critical attitude towards their own and their peers' performance. We designed a PA task to assess students' clinical skills (including reasoning, communication, physical examination and treatment skills) in a role-play that simulated physical therapy (PT) practice. Students alternately performed in the role of PT, assessor, and patient. Oral face-to-face feedback was provided as well as written feedback and scores.This study aims to explore the impact of PA on the improvement of clinical performance of undergraduate PT students.

METHODS

The PA task was analyzed and decomposed into task elements. A qualitative approach was used to explore students' perceptions of the task and the task elements. Semi-structured interviews with second year students were conducted to explore the perceived impact of these task elements on performance improvement. Students were asked to select the elements perceived valuable, to rank them from highest to lowest learning value, and to motivate their choices. Interviews were transcribed verbatim and analyzed, using a phenomenographical approach and following template analysis guidelines. A quantitative approach was used to describe the ranking results.

RESULTS

Quantitative analyses showed that the perceived impact on learning varied widely. Performing the clinical task in the PT role, was assigned to the first place (1), followed by receiving expert feedback (2), and observing peer performance (3). Receiving peer feedback was not perceived the most powerful task element.Qualitative analyses resulted in three emerging themes: pre-performance, true-performance, and post-performance triggers for improvement. Each theme contained three categories: learning activities, outcomes, and conditions for learning.Intended learning activities were reported, such as transferring prior learning to a new application context and unintended learning activities, such as modelling a peer's performance. Outcomes related to increased self-confidence, insight in performance standards and awareness of improvement areas. Conditions for learning referred to the quality of peer feedback.

CONCLUSIONS

PA may be a powerful tool to improve clinical performance, although peer feedback is not perceived the most powerful element. Peer assessors in undergraduate PT education use idiosyncratic strategies to assess their peers' performance.

Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback: retrospective cohort study

BACKGROUND

Healthy eating interventions that use behavior change techniques such as self-monitoring and feedback have been associated with stronger effects. Mobile apps can make dietary self-monitoring easy with photography and potentially reach huge populations.

OBJECTIVE

The aim of the study was to assess the factors related to sustained use of a free mobile app ("The Eatery") that promotes healthy eating through photographic dietary self-monitoring and peer feedback.

METHODS

A retrospective analysis was conducted on the sample of 189,770 people who had downloaded the app and used it at least once between October 2011 and April 2012. Adherence was defined based on frequency and duration of self-monitoring. People who had taken more than one picture were classified as "Users" and people with one or no pictures as "Dropouts". Users who had taken at least 10 pictures and used the app for at least one week were classified as "Actives", Users with 2-9 pictures as "Semi-actives", and Dropouts with one picture as "Non-actives". The associations between adherence, registration time, dietary preferences, and peer feedback were examined. Changes in healthiness ratings over time were analyzed among Actives.

RESULTS

Overall adherence was low-only 2.58% (4895/189,770) used the app actively. The day of week and time of day the app was initially used was associated with adherence, where 20.28% (5237/25,820) of Users had started using the app during the daytime on weekdays, in comparison to 15.34% (24,718/161,113) of Dropouts. Users with strict diets were more likely to be Active (14.31%, 900/6291) than those who had not defined any diet (3.99%, 742/18,590), said they ate everything (9.47%, 3040/32,090), or reported some other diet (11.85%, 213/1798) (χ(2) 3=826.6, P<.001). The average healthiness rating from peers for the first picture was higher for Active users (0.55) than for Semi-actives (0.52) or Non-actives (0.49) (F2,58167=225.9, P<.001). Actives wrote more often a textual description for the first picture than Semi-actives or Non-actives (χ(2) 2=3515.1, P<.001). Feedback beyond ratings was relatively infrequent: 3.83% (15,247/398,228) of pictures received comments and 15.39% (61,299/398,228) received "likes" from other users. Actives were more likely to have at least one comment or one "like" for their pictures than Semi-actives or Non-actives (χ(2) 2=343.6, P<.001, and χ(2) 2=909.6, P<.001, respectively). Only 9.89% (481/4863) of Active users had a positive trend in their average healthiness ratings.

CONCLUSIONS

Most people who tried out this free mobile app for dietary self-monitoring did not continue using it actively and those who did may already have been healthy eaters. Hence, the societal impact of such apps may remain small if they fail to reach those who would be most in need of dietary changes. Incorporating additional self-regulation techniques such as goal-setting and intention formation into the app could potentially increase user engagement and promote sustained use.

Enhancing self-protective behavior: efficacy beliefs and peer feedback in risk communication

In times of a high-impact safety incident citizens may have a variety of sources available to help them cope with the situation. This research focuses on the interplay of efficacy information in risk communication messages and peer feedback, such as responses on social network sites (SNSs) in the context of a high-impact risk on the intention to engage in self-protective behavior. The study pitted high and low efficacy information messages against supporting and opposing peer feedback (N = 242). Results show a significant interaction effect between efficacy information in a news article and peer feedback from SNS messages on both the intention to engage in self-protective behavior and levels of involvement. Participants who received the article with more efficacy information and also received supportive peer feedback via SNS messages were more likely to express higher levels of involvement and greater intentions to engage in protective behavior. When confronted with a low efficacious news article, the effect of peer feedback on these two variables was significantly stronger. Finally, implications for theory and government risk communication are discussed.

The effect of midterm peer feedback on student functioning in problem-based tutorials

Within Problem-Based Learning successful learning depends on the quality of cognitive, social and motivational contributions students make to the tutorial group. But at the same time, not all students in PBL automatically contribute in a high quality manner, which might impede successful group functioning. This study investigated whether peer process feedback combined with goal setting can be used to improve the quality of students' individual contributions. A mixed-methods explanatory design, in which 74 second-year Health Sciences students participated, combined a pre- and posttest with a focus group. The results indicated that the quality of the contributions only increased for students with a below average score on the pre-test. The qualitative data confirmed that the impact of the feedback could be increased by combining individual reflection by means of goal setting with face-to-face discussion. Another suggestion is to investigate whether midterm peer process feedback is more effective for first year students, because they are still developing their tutorial behavior, as opposed to second year students.

Neural circuitry underlying affective response to peer feedback in adolescence

Peer feedback affects adolescents' behaviors, cognitions and emotions. We examined neural circuitry underlying adolescents' emotional response to peer feedback using a functional neuroimaging paradigm whereby, 36 adolescents (aged 9-17 years) believed they would interact with unknown peers postscan. Neural activity was expected to vary based on adolescents' perceptions of peers and feedback type. Ventrolateral prefrontal cortex (vlPFC) activity was found when adolescents indicated how they felt following feedback (acceptance or rejection) from peers of low vs high interest. Greater activation in both cortical (e.g. superior temporal gyrus, insula, anterior cingulate) and subcortical (e.g. striatum, thalamus) regions emerged in response to acceptance vs rejection feedback. Response to acceptance also varied by age and gender in similar regions (e.g. superior temporal gyrus, fusiform, insula), with greater age-related increases in activation to acceptance vs rejection for females than males. Affective response to rejection vs acceptance did not yield significantly greater neural activity in any region. vlPFC response suggests cognitive flexibility in reappraising initial perceptions of peers following feedback. Striatal response suggests that acceptance is a potent social reward for adolescents, an interpretation supported by more positive self-reported affective response to acceptance than rejection from high- but not low-interest peers.