Elizabeth Katherine Molloy

• PhD, BPhysio (Hons)
• Professor at University of Melbourne

Introduction While peer teaching is often seen as benefiting learners, it can also benefit peer teachers. One possible mechanism is by building peer teachers' evaluative judgement or their ability to judge the quality of work of selves and others. This qualitative interview study explores how specialty medical trainees build evaluative judgement th...

The stigma of underperformance is widely acknowledged but seldom explored. ‘Failure to fail’ is a perennial problem in health professions education, and learner remediation continues to tax supervisors. In this study, we draw on Goffman’s seminal work on stigma to explore supervisors’ accounts of judging performance and managing remediation in spec...

Introduction: Studies of learning conversations in medical education suggest these interactions can be supervisor driven, monologic and may involve poor recall of events. Educators often use camouflaged comments to avoid upsetting learners, which can interfere with meaning making. Using video of clinical practice within learning conversations could...

There is limited research on the experiences of people in working to embed, integrate and sustain simulation programmes. This interview-based study explored leaders’ experiences of normalising a simulation-based education programme in a teaching hospital. Fourteen known simulation leaders across Australia and North America were interviewed. Semi-st...

The effectiveness of work performed through interprofessional practice is contingent on the nature and extent of communication between professionals. To date, there is little research exploring how the patterns of communication may impact interprofessional work. This study focused on communication during interprofessional meetings to better underst...

Introduction Clinical debriefing (CD) improves teamwork and patient care. It is implemented across a range of clinical contexts, but delivery and structure are variable. Furthermore, terminology to describe CD is also inconsistent and often ambiguous. This variability and the lack of clear terminology obstructs understanding and normalisation in pr...

Objectives: Residents in emergency medicine have reported dissatisfaction with feedback. One strategy to improve feedback is to enhance learners' feedback literacy-i.e., capabilities as seekers, processors, and users of performance information. To do this, however, the context in which feedback occurs needs to be understood. We investigated how re...

Introduction: Specialty trainees often struggle to understand how well they are performing, and feedback is commonly seen as a solution to this problem. However, medical education tends to approach feedback as acontextual rather than located in a specialty-specific cultural world. This study therefore compares how specialty trainees in surgery and...

Introduction Underperformance in clinical environments can be costly and emotional for all stakeholders. Feedback is an important pedagogical strategy for working with underperformance – both formal and informal strategies can make a difference. Feedback is a typical feature of remediation programs, and yet there is little consensus on how feedback...

The teaching and learning that takes place in clinical settings has a significant influence on the practice of future health professionals. This article describes the use of a logic model and case study methodology to evaluate an online and face-to-face video-club, a novel professional development activity designed with the aim of improving clinica...

Purpose: Interprofessional communication (IPC) in rehabilitation is important for patient care yet it has been shown to be variable and challenging. Existing research does not address the complexity of IPC in this setting. Understanding the influence of contextual factors on IPC may guide improvements to increase the effectiveness of communication...

Interprofessional communication in rehabilitation is important for patient care yet relatively few studies have investigated how it is enacted in this context. This study explored interprofessional communication of healthcare professionals working in rehabilitation teams.

Purpose: In competency-based medical education, workplace-based assessment provides trainees with an opportunity for guidance and supervisors the opportunity to judge the trainees' clinical practice. Learning from assessment is enhanced when trainees reveal their thinking and are open to critique, which requires trust in the assessor. If superviso...

Learning through work is a common feature of preparing health professionals for practice. Current understandings of work-integrated learning or a ‘work-based placement’, focus on students being consumers of experiences rather than providing a reciprocal benefit to the organisation in which they are placed. More nuanced understanding of the ways tha...

For trainees to participate meaningfully in workplace-based assessment (WBA) they must have trust in their assessor. However, the trainee’s dependent position complicates such trust. Understanding how power and trust influence WBAs may help us make them more effective learning opportunities. We conducted semi-structured interviews with 17 postgradu...

Background Face-to-face feedback plays an important role in health professionals’ workplace learning. The literature describes guiding principles regarding effective feedback but it is not clear how to enact these. We aimed to create a Feedback Quality Instrument (FQI), underpinned by a social constructivist perspective, to assist educators in coll...

Research associates self-regulated learning with academic achievement and lifelong learning. Although there is consensus surrounding the need for students to develop self-regulated learning skills, there is a paucity of research exploring how educators can foster student self-regulated learning. This study examines the teaching practices, beliefs a...

Conceptualizations of workplace learning have moved from knowledge acquisition to learning as participation in the practices and cultures of the workplace environment. Along with this has come an appreciation of applicability of sociocultural learning theories, which frame learning as occurring within "communities of practice" or learning being "si...

Purpose Effective communication in interprofessional rehabilitation teams is essential for optimal patient care. Despite the established importance, it remains unclear how interprofessional communication (IPC) within teams contributes to rehabilitation service delivery. The aim of this scoping review was to investigate how IPC has been described in...

Background Simulation is reported as an appropriate replacement for a significant number of clinical hours in pregraduate programmes. To increase access for learners, educators have looked to understanding and improving learning in observer roles. Studies report equivalent learning outcomes and less stress in observer roles. However, reports on the...

Context Feedback conversations play a central role in health professions workplace learning. However, learners face a dilemma: if they engage in productive learning behaviours (such as asking questions, raising difficulties, offering opinions or contesting ideas), they risk exposing their limitations or offending the educator. This highlights the i...

Feedback can improve students’ learning and performance on clinical placements, yet students are often dissatisfied with the process. Attempts to improve feedback frequently focus on faculty development programs without addressing learners’ capabilities to engage with feedback. For feedback to be effective, students need to understand its processes...

Medical educators are tasked with decisions on trainee progression and credentialing for independent clinical practice, which requires robust evidence from workplace-based assessment. It is unclear how the current promotion of workplace-based assessment as a pedagogical approach to promote learning has impacted this use of assessments for decision-...

Background: Effective communication between patients-clinicians, supervisors-learners and facilitators-participants within a simulation is a key priority in health profession education. There is a plethora of frameworks and recommendations to guide communication in each of these contexts, and they represent separate discourses with separate commun...

Many clinicians who take on a formal role of supervising or teaching trainees need to be taught how to teach and then continuously improve as educators. We describe the research-informed design of a novel professional development intervention that may be perceived by clinical educators as challenging, but being based on the key features of effectiv...

This chapter synthesises findings from observational studies of feedback in surgical education and the broader health workplace which illuminate the failure of feedback to do its job in improving trainee performance. Given this state of affairs, we argue for an alternative way of looking at feedback practices in surgical education. The recent frame...

Despite an increasing focus on assessment feedback, educators continue to find that simply replicating an effective feedback practice from one context does not guarantee success in the next. There is a growing recognition that the contextual factors surrounding successful practices need to be considered. This article reports on a large-scale mixed...

There is an increasing focus on notions of feedback in which students are positioned as active players rather than recipients of information. These discussions have been either conceptual in character or have an empirical focus on designs to support learners in feedback processes. There has been little emphasis on learners’ perspectives on, and exp...

This chapter offers a useful overview of the purpose, development and structure of this book on feedback impact. It begins by touching on the reason for this book and then provides an outline of the process of how the editors and authors worked together to break new ground. We then explain the structure of the book—describing the five parts: feedba...

The feedback literature has a habit of treating emotion as a form of interference. Therefore many guidelines for improving practice are geared towards reducing learners’ emotions so that messages can “get through” and take root. In this chapter, we present a case for a re-orientation of how we conceive the role of emotion in feedback. We use a soci...

This chapter focuses on influences, affordances and challenges for teachers in designing for (and identifying) feedback impact. We propose four key questions that need to be asked: Do learners know the purpose of feedback and their role(s) in it? Can learners make sense of the information? Can learners take action? What effects should we be looking...

This chapter discusses researching feedback inputs and processes to examine effects. Specifically, we promote a research agenda that contributes an understanding of how feedback works, for particular learners, in particular circumstances through research designs that take account of theory, occur in naturalistic settings and focus on students’ sens...

This chapter offers new insight regarding the theoretical, methodological and practical concerns relating to feedback in higher education. It begins with the construction of a new definition of feedback. We explain how feedback is a learner-centred process in which impact is a core feature. The chapter then explores the reasons why identifying, let...

Feedback can occur before and after assessment submission, but needs to be useful in order for students to improve their subsequent performance. Arguably, undergraduate students, and particularly international, online and new students, are especially in need of feedback to effectively engage in academic and disciplinary expectations. Therefore, thi...

Context: Research suggests that feedback in the health professions is less useful than we would like. In this paper, we argue that feedback has become reliant on myths that perpetuate unproductive rituals. Feedback often resembles a discrete episode of an educator "telling," rather than an active and iterative involvement of the learner in a futur...

Background: The Balance Intensity Scales (BIS) have been developed to measure the intensity of balance exercise in older adults. Objective: The objective was to determine whether the BIS for therapists (BIS-T) and exercisers (BIS-E) are unidimensional measures of balance exercise intensity, able to be refined using the Rasch model into a hierarc...

In this qualitative study, we report how Supervisors of Training, educational supervisors overseeing the learning of anaesthesia trainees, experience their role in practice. Using purposive sampling, we interviewed Supervisors of Training from across Australia and New Zealand. The interviews began by asking ‘what do you see as your role as a Superv...

Background Verbal feedback plays a critical role in health professions education but it is not clear which components of effective feedback have been successfully translated from the literature into supervisory practice in the workplace, and which have not. The purpose of this study was to observe and systematically analyse educators’ behaviours du...

This chapter discusses the development, implementation and evaluation of a learning intervention to enhance students’ workplace feedback literacy. Healthcare students want more feedback during placements. Students’ roles in feedback processes tend to be overlooked with most learning interventions focusing on professional development of educators, t...

Objectives The use of theory in research is reflected in its presence in research writing. Theory is often an ineffective presence in medical education research papers. To progress the effective use of theory in medical education, we need to understand how theory is presented in research papers. This study aims to elicit how theory is being written...

Objectives The literature focuses on teaching communication skills in the ‘classroom’, with less focus on how such skills are informally learnt in the healthcare workplace. We grouped healthcare work based on the cure:care continuum to explore communication approaches based on work activities. This study asks: 1) How do healthcare professionals bel...

This book asks how we might conceptualise, design for and evaluate the impact of feedback in higher education. Ultimately, the purpose of feedback is to improve what students can do: therefore, effective feedback must have impact. Students need to be actively engaged in seeking, sense-making and acting upon any information provided to them in order...

The tension between expressing vulnerability and seeking credibility creates challenges for learning and teaching. This is particularly true in health care, in which practitioners are regarded as highly credible and making errors can often lead to dire consequences and blame. From a transformative learning perspective, expressing vulnerability may...

Feedback practices represent a significant investment in resources and emotion for educators and students. While there are pockets of excellence, research continues to highlight that feedback practices cannot be simply parachuted from one context to another and be expected to work just as effectively. This paper presents twelve underlying condition...

Context Although communication with patients is essential to health care, education designed to develop patient‐centred communication often ignores patients’ voices. Patient stories may offer a means to explore patient experiences to inform patient‐centred communication skills education design. Objectives Our research questions were: (i) What are...

This chapter provides a synthesis of recent research into how technology can support effective feedback. It begins by adopting a definition of feedback in line with recent advances in feedback research. Rather than viewing feedback as mere information provision, feedback is viewed as an active process that students undertake using information from...

Since the early 2010s the literature has shifted to view feedback as a process that students do where they make sense of information about work they have done, and use it to improve the quality of their subsequent work. In this view, effective feedback needs to demonstrate effects. However, it is unclear if educators and students share this underst...

Clinicians who teach are essential for the health workforce but require faculty development to improve their educational skills. Curricula for faculty development programs are often based on expert frameworks without consideration of the learning priorities as defined by clinical supervisors themselves. We sought to inform these curricula by highli...

Objective The objective of this systematic review was to examine the effects of different balance exercise interventions compared with non-balance exercise controls on balance task performance in older adults. Design Systematic review. Data sources Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Scopus and Cochrane Data...

Critique has been levelled at the use of models for feedback practices that ignore context in health professions education. Models such as the ‘feedback sandwich’ are often adopted as rules to be followed regardless of the situation. In this chapter, we utilise an updated version of the Bronfenbrenner ecological framework of human development to un...

Background: Peer‑assisted learning (PAL) may enhance learning opportunities for students placed in pairs, and address the demand for student placements. The study aimed to (1) evaluate the effect of providing education on PAL to clinical educators (CEs) on activities undertaken by students and (2) explore CE and student perceptions of the clinical...

The development of balance intensity scales for therapists and exercisers has broad reaching implications for the study of balance exercise prescription. With a valid measure of balance exercise intensity, the optimal dosage of balance exercise to improve balance and prevent falls can now be further investigated. Similar to strength and aerobic tra...

This model, characterised by an upfront educational component for research participants, could be replicated in other health settings. This study demonstrates that it is possible for clinicians in a large tertiary health service network in Australia to incorporate recruitment and data collection for a large cohort study alongside usual clinical car...

There are dissonances between educators’ aspirations for assessment design and actual assessment implementation in higher education. Understanding how assessment is designed ‘on the ground’ can assist in resolving this tension. Thirty-three Australian university educators from a mix of disciplines and institutions were interviewed. A thematic analy...

Introduction: Peer-assisted learning (PAL) is an increasingly used learning method, with demonstrated equivalence to conventional teaching methods in students’ knowledge and skill gain. Despite this, student satisfaction with PAL is varied. There are few investigations of gender as a factor influencing students’ perceptions of peer-assisted learnin...

As teachers we often ask learners to be vulnerable and yet present ourselves as high status, knowledgeable experts, often with pre-prepared scripts. This paper investigates the metaphoric notion of “intellectual streaking” – the nimble exposure of a teacher’s thought processes, dilemmas, or failures – as a way of modeling both reflection-in-action...

Objective: The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. Design: Systematic review and qualitative synthesis. M...

Pressure on clinical educators to provide best practice education to growing student numbers is driving innovations in clinical education. Placing multiple students with a single clinical educator may increase capacity; however, little is known about the role and impact of peer-assisted learning (PAL) in these models. A systematic review of the lit...

Context: The accreditation of undergraduate medical education is a universal undertaking. Despite the widespread adoption of accreditation processes and an increasing focus on accreditation as a mechanism to ensure minimum standards are met in various fields, there is little evidence to support the effectiveness of accreditation. Traditionally, ac...

Background Simulation is widely used in health professional education. The convention that learners are actively involved may limit access to this educational method. The aim of this paper is to review the evidence for learning methods that employ directed observation as an alternative to hands-on participation in scenario-based simulation training...

Approach: Previous peer learning research results and a matrix of empirically derived peer learning activities were presented to local clinical education experts to generate discussion around the realities of implementing such activities. Potential barriers and limitations of and strategies for implementing peer learning in clinical education were...

The Balance Intensity Scale has been refined. The refined scale now requires evaluation of item fit and other metrics using data collected in the course of scale use. Additional testing is necessary to confirm that the refined scale functions in the same way as it did in the context of the now deleted items.

Engagement and education of therapists and healthcare consumers in the research design and scale development process was a key strategy in successful implementation of this research study across this health service. This model, characterised by an upfront educational component for research participants, could be easily reproduced in other health se...

Background: Feedback in clinical education is essential for the development of competent nurses. When the process is enacted well, it offers measured performance against standards required by the nursing health profession, promoting learning and behavioural change. Despite this, health literature describes numerous barriers to effective feedback p...

This study explored the contribution of peer-assisted learning (PAL) in the development of evaluative judgement capacity; the ability to understand work quality and apply those standards to appraising performance. The study employed a mixed methods approach, collecting self-reported survey data, observations of, and reflective interviews with, the...

Assessment as a field of investigation has been influenced by a limited number of perspectives. These have focused assessment research in particular ways that have emphasised measurement, or student learning or institutional policies. The aim of this paper is to view the phenomenon of assessment from a practice perspective drawing upon ideas from p...

Approach: This study aimed to describe PAL activities within the context of clinical placement learning and to explore students' perceptions of these activities. An ethnographic study was conducted to gather empirical data on engagement in clinical placement learning activities, including observations and interviews with students in their 1st clin...

A wide range of technologies has been developed to enhance assessment, but adoption has been inconsistent. This is despite assessment being critical to student learning and certification. To understand why this is the case and how it can be addressed, we need to explore the perspectives of academics responsible for designing and implementing techno...

Background: Peer-assisted learning (PAL) is increasingly used in medical education, and the benefits of this approach have been reported. Previous reviews have focused on the benefits of peer tutoring of junior students by senior students. Forms of PAL such as discussion groups and role-playing have been neglected, as have alternative teacher-lear...

Health professions education is characterised by work-based learning and relies on effective verbal feedback. However the literature reports problems in feedback practice, including lack of both learner engagement and explicit strategies for improving performance. It is not clear what constitutes high quality, learner-centred feedback or how educat...

There are many excellent publications outlining features of assessment and feedback design in higher education. However, university educators often find these ideas challenging to realise in practice, as much of the literature focuses on institutional change rather than supporting academics. This paper describes the conceptual development of a prac...

Effective balance rehabilitation is critically important to the ageing population. Optimal exercise prescription for balance rehabilitation has not been described, as there is no measure of balance exercise intensity. To rate the intensity of balance exercise, an item-set is required. The aim of this study was to explore verbal and non-verbal marke...

Clinicians require specific skills to teach or supervise students in the workplace; however, there are barriers to accessing faculty member development, such as time, cost and suitability. The Clinical Supervision Support Across Contexts (ClinSSAC) programme was designed to provide accessible interprofessional educator training to clinical supervis...

Low back pain is the highest ranked condition contributing to years lived with disability, and is a significant economic and societal burden. Evidence-based clinical practice guidelines are designed to improve quality of care and reduce practice variation by providing graded recommendations based on the best available evidence. Studies of low back...

Introduction/ Background PAL has been used amongst medical students largely to facilitate the transfer and construction of knowledge. Peers have also assessed performance, on written tests and professionalism, in clinical environments. The correlation between peer and staff assessment has been positive, albeit weak. Less is known about the benefit...

Question: What are the experiences of students and clinical educators in a paired student placement model incorporating facilitated peer-assisted learning (PAL) activities, compared to a traditional paired teaching approach? Design: Qualitative study utilising focus groups. Participants: Twenty-four physiotherapy students and 12 clinical educa...

We all experience the influence of feedback in our working lives, and there is strong evidence to suggest that it is an important mechanism in learning. Why is it then that learners complain more about feedback than any other element in their programs? This workshop explores the ‘problem of feedback’ and identifies some of the reasons as to why it...

Question: What is the efficacy and acceptability of a peer-assisted learning model compared with a traditional model for paired students in physiotherapy clinical education? Design: Prospective, assessor-blinded, randomised crossover trial. Participants: Twenty-four physiotherapy students in the third year of a 4-year undergraduate degree. Interv...

Objective: In nursing, where communication is crucial for collaboration with colleagues, informing and reassuring clients as well as advocating. Use of appropriate styles is fundamental. Consideration of nursing students' listening and communi-cation styles is necessary to understand whether this area needs further enhancement in the curriculum. Ye...

Background Monash University medical students are oriented to Peer Assisted Learning (PAL) in their pre-clinical years. There are fewer formal PAL activities on students’ clinical placements. When surveyed, Year 3 students reported they used PAL frequently, though felt underqualified to judge their peers’ performance, and lacked skills to provide f...

Introduction/background: Peer assisted learning (PAL) may promote life-long skills such as communication, teamwork, time-management and self-direction (Secomb 2008), and may also increase the efficiency of a clinical placement (Sevenhuysen 2013). At Monash University, medical students have been encouraged to use PAL for many years, however little i...

Interprofessional education is increasingly a core component of health professional curricula. It has been suggested that interprofessional education can directly enhance patient care outcomes. However, literature has reported many difficulties in its successful implementation. This study investigated students' perceptions of participating in an on...

This chapter focuses on the role of feedback in learning with particular emphasis on its effect on learner performance, motivation and self-regulation. The authors provide a critical account of definitions and models of feedback, tease out the conceptual roots of practice guidelines and highlight how individual, relational and environmental factors...

How has balance challenge intensity been reported in trials of balance exercise interventions? Are there any instruments designed to measure the intensity of balance challenge in balance training exercises? Systematic review of randomised trials of balance training exercises. Older adults, ie, the majority of subjects were aged over 55 years. Balan...

Background Demand for clinical placements continues to outstrip supply. Peer assisted learning, in various formats, has been trialed to increase training capacity and facilitate student learning during clinical education. There are no documented examples of measurable or repeatable peer assisted learning models to aid clinicians in implementing the...