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Feedback to enhance student learning: facilitating interactive feedback on clinical skills

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Abstract

Increasing the amount and quality of feedback offered by clinical educators to students and trainees should lead to long term benefits in patient care. This paper highlights the importance of giving interactive feedback to learners on their clinical skills. The role of feedback in student learning is explored through an examination of a range of models of education. The planning and preparation needed for effective feedback is described and a model for identifying the most valuable feedback content is provided. Three approaches to facilitating feedback are described and details are given of the interactive approach supported by current research findings. The final section deals with managing the response to feedback from students and trainees.

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... Following discussions, we agreed that the sessions were primarily intended to enhance student learning and prepare them for their roles as staff nurses. It was agreed that students would not be assessed but would get feedback and debriefing on their performance (Cantrell, 2008;Hill, 2007). It was also agreed that if a student made a potentially serious error, it would be highlighted and discussed with the student individually. ...
... Debriefing sessions also permit discussion of the potential problems if care is overlooked or incorrect interventions are performed. Debriefing sessions also enable students to recognize their own limitations so that they can seek help or advice (Fruscione & Hyland, 2010;Hill, 2007). ...
Article
This article describes the processes of developing and implementing a ward management exercise for 4th-year student nurses in preparation for the role of staff nurse. In 2005 the need to develop a teaching method that would enable students to consolidate the skills of caseload management, critical thinking, decision making, and prioritizing patient care was identified. Simulation was identified as a way of addressing these skills, and a project team including both academic and clinical colleagues developed the exercise. This article presents the experience of designing and implementing the exercise and discusses the challenges encountered.
... For example, the witnessing of childbirth can make an indelible and rewarding imprint on students (McLean, 2004). In addition, developing a collaborative peer group (Buddeberg-Fischer & Herta, 2006; Santucci, Lingler, Schmidt, Nolan, Thatcher & Polk, 2008), providing appropriate clinical feedback and working with clinician role-models can impact positive professional attitudes, skills, and characteristics, thereby assisting students in their developmental process as they become doctors (Branch & Paranjape, 2002; Dornan, Boshuizen, King, & Scherpbier, 2007; Hill, 2007; Kutcher, 1984; Lin, Shiah, Chang, Lai, Wang & Chou, 2004; Wood, 2000). Implementation of explicit programmes to develop self-care practices for medical students are also deemed to be important as they have a positive impact on quality of life (Estabrook, 2008; Hassed, Lisle, Sullivan, & Pier, 2009). ...
... Finally, major feedback addresses levels of competency related to inadequate performance and is thus a patient safety issue. It is commonly thought, by medical educators, that feedback needs to be constructive, specific, timely and measurable and change seen to be manageable and achievable (Branch & Paranjape, 2002; Hill, 2007; Wood, 2000). ...
Article
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There is growing literature in the area of medical students' quality of life. As far as we know, no qualitative studies have investigated the links between students' quality of life issues and their motivation to learn. The key question that drove the present study was: Is there a correlation between students' quality of life and their motivation to learn? Accordingly, the purpose of this study was to explore links between quality of life and motivation to learn. Data was gathered from medical students studying in years four (n = 6) and five (n = 13). Employing two focus groups a small group diagnostic process was used to ascertain levels of consensus around certain important areas. Student commentaries revealed some interesting and thought provoking insights. The year four students uniformly (100% agreement) experienced sleep problems and felt anxious and uncertain in the clinical setting. The year five students' consistently (100% agreement) cited problems associated with pain, injury and sleep deprivation. Moreover, they regularly felt that clinicians would perceive them as 'weak' if they took time off. These findings have pastoral and academic implications for community and university management, educators, student service personnel, and students.
... Feedback encourages the student to reflect on their capabilities, develop critical thinking and selfreflection (Gaberson and Oermann 2010) and make suggestions for future growth (Howard 2009). Feedback gives the mentor valuable information about the strengths and weaknesses of their own teaching strategies, enabling them to refine their future teaching (Hill 2007). Feedback between the mentor and student should be an interactive communication given in a timely manner (McKimm 2009), informing the student of whether they are achieving the expected standards (Hill 2007). ...
... Feedback gives the mentor valuable information about the strengths and weaknesses of their own teaching strategies, enabling them to refine their future teaching (Hill 2007). Feedback between the mentor and student should be an interactive communication given in a timely manner (McKimm 2009), informing the student of whether they are achieving the expected standards (Hill 2007). Community midwifery placements, where the mentor and student travel together between visits, offer a perfect opportunity for regular feedback and discussion. ...
Article
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This paper aims to give an overview of the role of the mentor within the sphere of the evaluation of learning, with particular emphasis on the intermediate interview and student reflection on their learning experience as formal tools for evaluation. Although the terms 'evaluation' and 'assessment' are often used in similar contexts, it is important to distinguish between the two concepts. The importance of evaluation of learning cannot be over emphasised as it is an important part of ensuring that students develop as expected (Nursing and Midwifery Council (NMC) 2008). Therefore, failure to evaluate learning can have a negative impact on the student and their learning throughout their programme of study.
... Both of these feedback models place emphasis on the trainee as an active participant in the learning process, and thus are often referred to as "interactive approaches". Hill (2007) believes that the interactive methods avoid a number of pitfalls. For example, the approaches prevent the build-up to the " . . . ...
... While undoubtedly extremely helpful, it is a time consuming method and therefore has limited use in many clinical settings. Nevertheless, the CA is useful when employed in conjunction with the interactive methodologies (Hill, 2007). For example, a supervisor might ask a trainee to record his/her session and review the recorded therapy prior to supervision, choosing excerpts that demonstrate good and poor skills. ...
Article
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As a trainee cognitive therapist in the early 1990s, I was taught the Sh*t Sandwich by my supervisor. I continued to use this technique for many years without seeing the need to extend my repertoire of feedback strategies. Aims: This article describes a number of other feedback techniques, raising awareness of the processes underpinning feedback, and facilitating reflection on feedback methods. Method: This review examines feedback and the methods of feedback used to improve clinical competence. Results: Evidence informs us that the use of good feedback has a significant effect on learners’ outcomes (Milne, 2009). However, despite recognition of its importance, many supervisors fail to give adequate feedback and utilize methods that are sub-optimal. One such problematic method is the notorious “Sh*t Sandwich” (SS), which attempts to hide criticism within a cushion of two positive statements. This paper looks at various models of giving negative and positive feedback, suggesting that our repertoire of feedback methods may require expanding. Conclusion: The review suggests that feedback is a complex process and methods that place an emphasis on the learner as an active participant in the learning process (i.e. interactive approaches) should be encouraged. The paper suggests that negative feedback should generally be avoided in favour of constructive support, accompanied by specific, descriptive, balanced feedback, with new learning being consolidated by role play. Generally, feedback should be given about the task rather than the person, but when it is personalized it should relate to effort rather than ability.
... More recently in the School of Medicine at Southampton University, staff developers have devised a tool to help teachers determine the content of feedback. The tool encourages clinical educators to identify specific areas for feedback related to learning goals and the point of observation, and to take an interactive approach (Hill, 2007). ...
... 2. During the 1990s the 'chronological account' was favoured (Hill, 2007). In the chronological account, observers keep detailed notes and then replay the observation to the learners, as it occurred over time, bringing in both negative and positive comments along the way. ...
... [46,47] This feedback adopted the "competency model" strategy. [48,49] Staff members discussed weaknesses and areas for development with students that demonstrated low levels of competence. Alternative approaches were therefore suggested, and a relaxed conversation was encouraged through engaging the student with reflective discussion assisted by open questions. ...
... Alternative approaches were therefore suggested, and a relaxed conversation was encouraged through engaging the student with reflective discussion assisted by open questions. [47,49] On the other hand, competent students were advised of how to refine their skills and raise their awareness of detail. Moreover, competent students are more prone to develop bad habits which are difficult to change if went unnoticed. ...
Article
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Undergraduate dental students acquire their clinical skills through the hands-on training on phantom heads. This is essential to develop their skills and experience and to ensure they can undertake safe and competent dental procedures on patients. However, the literature lacks a comprehensive approach capable of assessing dental clinical simulation skills objectively and at the same time incorporating all the tools necessary for effective learning. A brief overview of the literature regarding clinical skills assessment was performed to define specific recommendations for implementation of dental clinical skills assessment tools. Selected best theories and methods for a successful package of tools were gleaned from the existing medical and dental literature. This paper defines specific recommendations for implementation of dental clinical skills assessment tools necessary for effective teaching of tooth cavity preparation in clinical simulation laboratories. The recommended approach of comprehensive assessment was broken down into three main components (1) clinical simulation skill assessment, (2) self-assessment, and (3) student feedback and reflection. The conclusions and recommendations offered herein are intended to enhance course design and current teaching methods in dentistry rather than replace them. The following recommendations were made: (1) Dental schools need to seek to ensure that valid and reliable standard settings are applied to their assessments which, if accomplished, are very likely to enhance their educational outcomes. (2) It is important to get students to understand and positively respond to feedback which can be achieved by creating a module culture in which students are encouraged to share and discuss their mistakes openly. Proper feedback will ensure better performance and improved self-assessment skills. (3) Staff members should utilize a more consistent pattern of feedback and review their techniques periodically to continually improve the teaching process. Such recommendations, if enforced thoroughly, would be helpful in aiding tutors and course instructors assess dental clinical simulation skills components objectively and identify the clinically weaker students.
... Feedback is not only integral to student satisfaction (Higgins et al, 2002) but also a key factor in student success (Hill, 2007) and has been widely researched due to its massive potential to enhance learning, remaining one of the top priorities of teaching practitioners (Carless and Bound, 2018). Diverse conceptions of feedback have been identified over time, with more traditional approaches considering feedback as the 'product' of a 'transmission process' in which effective formulation and delivery would suffice (Carless, 2015) shifting into more 'dynamic' approaches considering feedback as an 'interactive' process (Nicol, 2010), within which 'shared and individual interpretations are developed through dialogue, sense-making and co-construction between participants' (Carless and Bound, 2018, p.253). ...
... The learning cycle moves through four phases:  Active experimentation; students implement and apply the concluded theories and concepts into in new situations to solve a problem. Hill (2007) identifies the critical role of feedback in the learning cycle, by promoting reflection and considering how theory is translated into practice. The feedback loop is also clearly explained by Ashafiq in 2017 ( figure 2). ...
Article
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Introduction: It was a challenge to design a feedback pathway for distance learning course that deals with complexand ambiguous clinical subject like organ transplantation. This course attracts mature clinicians (n=117 spread overthree modules) from 27 countries where in addition to the time and zone barriers; there are cultural, institutionalbackground and also ethnic barriers. In addition to the challenges faced in designing the curriculum and assessmentthat match this diverse group of students, we have to deliver a quality feedback to achieve our leaning objective. Howwould we construct and deliver this feedback to students you have not seen (in a virtual classroom) and may be on adifferent continent of this busy planet?Methods: We analysed the published data on feedback with reflection on the nature of this course and the pedagogyused while considering the diversity of the students joined this courseConclusion: In this distance-learning course constructing a quality feedback to the students is more technicallydemanding compared to a traditional course. Students in distance learning need much more support and feedback thanin a traditional course. There is a potential threat that these students feel isolated in their own online world and may notengage with this virtual educational environment properly.
... Realising the value of effective and timely feedback in formative assessment is critical to the trainee's progression through the educational process. Feedback that is constructive and applicable to the learner supports reflection and leads to improvements in clinical skills [19,20]. The use of multisource feedback both for trainees and trained specialists has been shown to improve behaviour [21]. ...
Article
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Preclinical data have shown that high concentrations of the antitussive POV can affect hERG channels in vitro , but do not alter the QT interval even at very high doses/plasma levels in dogs in vivo . This randomised, placebo-controlled, single-blind, 2-way crossover clinical trial in 18 (9 female and 9 male) healthy volunteers investigated effects of POV on the ECG including the QTc interval following the administration of a supratherapeutic single oral dose of 121.5mg POV (192mg POV citrate in 90ml syrup). This single dose corresponds to the maximum total daily dose recommended for the treatment of dry cough (20mg to 30mg POV up to 4 times daily). ECGs were continuously recorded over 24h, and triplicate 12-lead ECGs of 10s duration each were extracted. PR, QRS, QT, QTcN, QTcF, and RR intervals as well as heart rate were determined (QTc: QT interval corrected for influences of HR (QTcF=Fridericia formula, QTcN=population method)). Neither QTcN nor QTcF showed notable findings (new onset of QTc intervals>450ms, changes from baseline in QTc > 30ms) regarding absolute or relative prolongations of the QTc. QTcN and QTcF changes to baseline remained below 2.3 ms throughout the observation period. The highest upper limit of the Confidence Interval of the difference to placebo was 8.5 ms. Also QT, HR, PQ, and QRS did not reveal any relevant findings. No clinically relevant abnormal morphological ECG findings were documented for POV. POV given as a supratherapeutic single dose (121.5mg, corresponding to 192 mg POV citrate) did not affect the ECG (in particular not the QTc-interval) in healthy subjects.
... 58 Hill argues that feedback plays an important role in Kolb's cycle as it supports the process of reflection and the consideration of new and more in-depth theories, and helps the learner plan more productively for their next learning experience. 59 Improving classroom learning through the use of assessment has also been shown to be dependent on the provision of feedback to learners, in order to help them recognise both the standards they are aiming for and the next steps they need to take in the learning process. 60 The lack of emphasis on feedback in surgical simulation studies may be because such feedback from expert tutors must come at an additional cost in both man-power and time that is potentially difficult to meet. ...
Article
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Objectives To establish the current state of knowledge on the effect of surgical simulation on the development of technical competence during surgical training. Methods Using a defined search strategy, the medical and educational literature was searched to identify empirical research that uses simulation as an educational intervention with surgical trainees. Included studies were analysed according to guidelines adapted from a Best Evidence in Medical Education review. Results A total of 32 studies were analysed, across 5 main categories of surgical simulation technique - use of bench models and box trainers (9 studies); Virtual Reality (14 studies); human cadavers (4 studies); animal models (2 studies) and robotics (3 studies). An improvement in technical skill was seen within the simulated environment across all five categories. This improvement was seen to transfer to the real patient in the operating room in all categories except the use of animals. Conclusions Based on current evidence, surgical trainees should be confident in the effects of using simulation, and should have access to formal, structured simulation as part of their training. Surgical simulation should incorporate the use of bench models and box trainers, with the use of Virtual Reality where resources allow. Alternatives to cadaveric and animal models should be considered due to the ethical and moral issues surrounding their use, and due to their equivalency with other simulation techniques. However, any use of surgical simulation must be tailored to the individual needs of trainees, and should be accompanied by feedback from expert tutors.
... Similarly, each action or decision made by an individual generates an abundance of feedback. In order to learn, individuals use some of the feedback to evaluate an action or decision (Hill 2007;Kolb 1984), and a self-regulated individual has the ability to use the information to change future behaviors (Ryan and Deci 2016;Zimmerman 2000). The challenge remains that in order for an individual to grow from feedback they must have calibrated their brain to attend to feedback that is both relevant and of high quality (Bol and Hacker 2012). ...
Article
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This paper proposes a model that integrates mindfulness, ego, and mindset as filters of the information available for professional learning. The paper explores connections between mindset, ego, and mindfulness that promote or inhibit an educator’s ability to use feedback for learning. A leader’s commitment to creating spaces for meaningful use of all types of feedback promotes a school climate that encourages risk taking in learning. Mindfulness, the cultivation of the ability to pay attention to the present moment non-judgmentally, is a prerequisite skill to the effective delivery and use of feedback to promote professional learning. The development of mindfulness requires practice of a method and the continual application of mindfulness to remain open to learning from feedback.
... Involvement and engagement of students both within the learning environment and the wider institution encourages retention (Tinto, 1993). Engagement with learning enhances intrinsic motivation and deeper learning (Carini et al 2006), and good feedback given in a timely manner enhances reflective practice (Hill, 2007). It has been suggested that appropriate and wellstructured feedback is the single most important factor in enhancing student achievement (Hattie, 2003;Hattie & Timperley, 2007). ...
Article
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Student expectations with regard to what comprises quality in higher education can impact upon their learning, engagement and overall satisfaction. Perceptions of quality are not always clearly articulated and may vary by gender, ethnicity and year of study. In this study, undergraduate students completed a questionnaire indicating whether they agreed, disagreed or were unsure about 15 statements related to quality in higher education. A total of 340 students across four year groups participated (Levels 3-6), with more female than male participants and a range of ethnicities represented. There was broad unanimity in the recognition of the importance of both teaching and learning and relationships with academic staff in defining quality. Overall, there were low levels of satisfaction with the amount of contact with academic staff and uncertainty about whether students thought they were getting a high quality education. Some differences in relation to support services were seen in different ethnic groups, and more males than females were satisfied with support services although this varied by year group, and student numbers were small. These results suggest the importance of clearly articulating what is available in terms of support (academic, pastoral, study and health) to all students. The teaching and learning experience, and relationships with academic staff are clearly important and given the uncertainty about overall perceptions of quality, these aspects need to be highlighted to students so that they understand the value of what they are receiving.
... According to Lewis (2004), through feedback, teachers become aware of the information about the students' learning progress and evaluate their teaching. Hill (2007) had a strong affinity that 'Feedback plays a significant role in ensuring that learners move around the learning cycle. For example, feedback supports the process of reflection and the deliberation of new or more in-depth theory. ...
... Another aspect that can be included in the description of learner characteristics is the concept of learning styles (Lightbown & Spada, 1999). Individuals may prefer to use different strategies when they learn new things, and correction practice can be considered as a part of these learning preferences (Hill, 2007). O 'malley and Chamot (1990) also have stated that preferred strategies for giving or receiving feedback can be associated with learning styles. ...
Article
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This study investigates the preferences of EFL learners for oral corrective feedback in relation to their learning styles in order to determine whether there exists a relationship between the two. The sample consisted of 348 preparatory class students studying English as a Foreign Language at a state university in Turkey. A questionnaire was administered to explore learners’ oral corrective feedback preferences, and a learning style inventory was utilized to classify participants’ learning styles. To analyse the obtained data, the frequency, percentage, mean and standard deviation values were calculated, and a Chi-square test was employed to determine whether there existed a relationship between student feedback preferences and their learning styles. Most participants were classified as divergent learners, and they seemed to expect their teachers to provide frequent feedback. Moreover, they believed that frequent and serious errors should be addressed more often than occasional and minor ones. Explicit feedback, clarification and elicitation were the most preferred types of feedback, with teachers being the most favored source. These results suggest that learning styles do not account for students’ feedback preferences and provide an explanation in terms of learners’ varied preferences. Therefore, it has been concluded that the concept of learning styles is irrelevant for understanding learner feedback preference.
... Grant Wiggins, citing several authors (Bransford, Brown, & Cocking, 2000;Hattie, 2008;Marzano, Pickering, & Pollock, 2001) states that by teaching less and providing more feedback, teachers can produce greater learning. Hill (2007) identifies feedback as the element that support learners in moving round the learning cycle. It supports the process of reflection and the consideration of new or more in-depth theory, and helps the learner plan productively for the next learning experience (Multiprofessional Faculty Development, 2018). ...
Conference Paper
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This paper presents the experience conducted in the framework of the Erasmus+ FeedBack Project, which aims at developing the practice of feedback through arts. The article introduces the practice of feedback as essential tool to enhance teaching and learning activities in the different level of education, with a specific focus on higher education. The FeedBack project has developed an Art-Based Feedback Model, which has been firstly defined in terms of actors, who give and receive feedback through different channels. Furthermore, the model has been integrated with the concept of Art-Based Initiatives, directly related to processes of Sustainability, Inspiration and Transformation implemented in teaching and learning contexts. Through an open and integrated virtual and face-to face strategy, that includes a digital toolkit, webinars, Massive Open Online Courses, events and workshops, the Arts-based FeedBack Model has been disseminated in several countries, stimulating the discussion and innovating the teaching and learning practices. This strategy lead to positive outcomes in terms of raising awareness of the topic, supporting the design and personalisation of the feedback process itself and, thus, enhancing the teaching and learning experience, especially in higher education contexts.
... The CEG Framework suggests a 5-step process; introduction (linking current teaching with previous and future practice), guided practice (videos, podcasts, reading), challenge activity (quiz, discussion forum), reflection and webinar. This provides structured learning from knowledge acquisition to application, with reflection completing the learning cycle (Hill, 2007) through the development of self-reflective attitudes and skills for life-long learning and self-monitoring (Boud and Falchikov, 2007). Given the nature of all online teaching, the format needs to be clearly communicated, consistent and organised. ...
Article
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The transition to online learning is an accepted and anticipated change across all higher education institutions. These changes have become even more relevant to healthcare education given the challenges posed by COVID19. This paper describes the application of the Cambridge Education Group Pedagogic Framework (2018) to online dental education, specifically the conversion of a face-to-face ‘Transition to Clinical Practice’ module in paediatric dentistry. The framework has a foundation in medical education and holds great value for clinical academics across all healthcare disciplines in the design and implementation of online teaching. This affords educators much needed structure and assistance in meeting the needs of our students in this era of online learning. The advantages and disadvantages are explored, illustrated by student feedback, following a pilot implementation at a Dental School in the United Kingdom.
... Feedback should be timeous and detailed, so that it serves a meaningful purpose for the learner. Hill (2007) actually termed feedback fuel which drives performance in commenting on its importance. ...
... To overcome the problems, the students need feedback that can assist them to write well-covering content, organization, language use, and mechanics. Hill (2007) identifies the important role of feedback in the learning cycle. The cycle is similar to plan, do, reflect, and act. ...
... Feedback is not only integral to student satisfaction (Higgins, Hartley and Skelton, 2002) but also a key factor in student success (Hill, 2007) and has been widely researched due to its substantial potential to enhance learning, remaining one of the top priorities of teaching practitioners (Carless and Boud, 2018). Diverse conceptions of feedback have been identified over time, with more traditional approaches considering feedback as the 'product' of a 'transmission process' in which effective formulation and delivery would suffice (Carless, 2015) shifting into more 'dynamic' approaches considering feedback as an 'interactive' ...
Book
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For international students around the world, 2020 was a year like no other. The very dream of travel and study in another country itself was threatened by a pandemic that spread across the globe resulting in travel restrictions, health lockdowns and grounded flights. Some students who had their cases packed to study in another country found themselves studying at home in another timezone. Others who had looked forward to gaining language skills through direct teaching and the ease of social interaction found themselves grappling with online education in their student accommodation. We all learned new vocabulary – Teams, Zoom, break out rooms – as we attempted to take ourselves and our students Off Mute. Of course, it wasn’t only students who were affected. 2020 saw professionals in English for Academic Purposes themselves locked down, teaching from home from spare rooms or kitchen tables, and in the process undertaking an intense period of professional development as we learned in real time how online teaching and support could help us reach and sustain our students. Barely any aspect of our practice was unaffected as challenge drove our own innovation and learning. Necessity is said to be the mother of invention. So what did we learn? And what do we want to retain and share with one another as the pandemic continues, and in the knowledge that international education may be permanently changed after the storm has passed? In the eight narratives included in this collection, colleagues from different UK universities generously share their experience of developing context-appropriate solutions in the early stages of the 2020 pandemic. They reflect on what they learnt from the experience and on what they themselves and others can take forward into future practice.
... Additional in-class activities on typical errors in blood pressure measurement did not improve their performance further. Moreover, this result underlines the importance and benefit of feedback for students to foster clinical skills as described in the literature [58][59][60][61][62][63]. With the omission of the additional in-class activities, the developed flipped classroom-like approach is efficient, as it leads to saving time and staff while maintaining comparable outcomes. ...
Article
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For reliable blood pressure measurement, various potential sources of inaccuracies need to be considered to avoid incorrect decision-making. Pharmacy students should be sensitized and taught the skill accordingly. One strategy to teach students’ blood pressure measurement skills might be through a blended learning approach in a flipped classroom-like setting. With a randomized two-arm study among pharmacy students in their eighth semester, the required extent of in-class session in the scope of a blended learning approach in a flipped classroom-like setting was evaluated. Participants’ self-confidence and self-perceived proficiency were evaluated through a survey, and participants’ blood pressure measurement performance was assessed by objective structured clinical examination (OSCE). Participants’ satisfaction with, and perception of, the flipped classroom were also surveyed. The extended in-class activities did not result in a significantly higher increase of participants’ OSCE score and self-assessment score when compared to the brief in-class session. Both in-class sessions yielded a significant increase in the OSCE scores as well as in the self-assessment scores. Moreover, the teaching approaches were predominantly well-received by the students. The use of both flipped classroom-like approaches improved pharmacy students’ blood pressure measurement performance, though the brief in-class session was sufficient. Students’ self-confidence/self-perceived proficiency in blood pressure measurement skills increased similarly in both settings.
... Multisource feedback and formal assessments have a role here in flagging up previously unidentified problem areas. Another way of looking at these issues is the 'competency model' of professional development (Proctor, 2001; Hill, 2007) (Table 3). In this model teachers also help learners move through four stages of development: from unconscious incompetence, where the unskilled learner is also unaware of his/her failings, to unconscious competence , or a state of more intuitive or freeflowing expertise. ...
Article
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Clinical teachers and educational supervisors work with a range of students and trainees on different programmes. Learners from diverse backgrounds have different learning needs which can be difficult to assess. Teachers who pay attention to individual learners' needs will help learners get the most from their training. This can be enhanced through the use of tools such as professional development plans and formal assessments.
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Objectives: Providing feedback to medical students improves the quality of medical education. However, there is still a paucity of published data on feedback, particularly in the Gulf region. The aim of this study is to assess the feedback given to medical students and examine the obstacles and predictor factors preventing medical staff from providing their students with appropriate feedback. Methods: This cross-sectional study was conducted at the College of Medicine, Taibah University, KSA. All teaching staff were invited to fill in a predesigned structured questionnaire about socio-demographic characteristics, data related to feedback given to students the previous academic year, and obstacles preventing them from providing appropriate feedback. Results: Of the 110 invitees, 95 faculty members responded (response rate of 86.4%), and 65.3% reported giving feedback (95% CI = 55.8%-74.8%). There were no significant differences in the characteristics of the given feedback when analysed according to staff gender, department, degree, and academic rank. The mean number and duration of the given feedback were significantly higher among professors, followed by assistant then associate professors respectively. Self-confidence, being judgmental, no time to give appropriate feedback (female and clinical staff), teachers' inadequate skills in giving feedback (basic sciences staff), and absence of students' advisorship (male staff) were the most important obstacles to providing feedback. Conclusions: This study showed that a considerably high proportion of medical staff provide student feedback. There is a need to improve obstacles that potentially prevent giving appropriate feedback to medical students and to provide remediable solutions.
Chapter
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This chapter reviews the educational, cultural, and linguistic factors that contribute to international medical graduate physicians’ perceptions of feedback and self-assessment as high-risk behaviors. Lack of exposure in medical school to feedback, limited role modeling of self-reflection, and an emphasis on certain cultural values all contribute to a high level of anxiety about the feedback process. This anxiety can be interpreted by faculty as disinterest or lack of motivation. Functioning in a second language can impact relationships with patients and supervisors’ assessment of residents’ capabilities. Practical guidelines for the giving and receiving of specific behaviorally based feedback and for organization of clinical skills verification examinations are offered. The relationship between feedback and evaluation is reviewed.
Article
The vicarious learning method (by observation) is used to help learners emulate their teachers' behaviours. The experiential learning method (by experience) is traditionally used thereafter, so that learners can apply these behaviours to a given situation. Both methods are widely utilised within clinical skills training. A clinical teacher may well face the question of whether a learner can complete a certain clinical task without having seen it performed before. Therefore, clinical teachers will need to determine which method, vicarious or experiential, is most effective for their learners. To help explore this, the author reflects on two examples from dental teaching practice, followed by discussion of the need to also observe soft skills; provide meaningful feedback; be a good role model; facilitate deep learning; know our learners, and implement learner-centred learning. Collectively, this reveals that although experiential learning may be possible and beneficial by itself, further research is required to fully support this.
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