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SHORT COMMUNICATION
Year : 2018  |  Volume : 9  |  Issue : 2  |  Page : 100-102

Feedback – Time for learner-centric approach


1 Department of Pharmacology, MMIMSR, Ambala, Haryana, India
2 Department of Surgery, GMCH, Chandigarh, India

Date of Web Publication27-Nov-2018

Correspondence Address:
Dr. Divya Goel
1154-A, Sector 32, Chandigarh
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjmsr.mjmsr_35_18

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  Abstract 


Feedback has been recognized as pillar for effective clinical training. Feedback is a complex, bidirectional process between educator and learner which is influenced by a number of factors. Recently, there is shift from an educator-centric approach to a learner-centric approach that aims to understand how learners seek, receive, and incorporate feedback in their learning process. The objective of this paper is to understand various factors which influence the learner role in learner-centric approach.

Keywords: Competency, feedback, learner centric


How to cite this article:
Goel D, Gupta S. Feedback – Time for learner-centric approach. Muller J Med Sci Res 2018;9:100-2

How to cite this URL:
Goel D, Gupta S. Feedback – Time for learner-centric approach. Muller J Med Sci Res [serial online] 2018 [cited 2018 Dec 11];9:100-2. Available from: http://www.mjmsr.net/text.asp?2018/9/2/100/246172




  Learner-Centric Approach………in Feedback Top


Most of the postgraduate learning occurs during their clinical and bedside works. Competency-based medical education increasingly recognizes the importance of feedback for achieving the desired level of competency during that period.[1] If feedback is not given, the learner will continue to perform in the same way. Feedback helps the learner to see the gap between his/her performance and the desired level of competency. As feedback is given by teacher to learner, for many years, the focus has been on the effective feedback delivering method. However, still, feedback practice has not been an integral part of the routine teaching–learning process, and many studies have shown that students do not get either any feedback or ineffective feedback.[2] Recently, there has been shift in feedback process from teacher-centric model to learner-centric model. Rather than focusing on the feedback delivering method, now, the focus is on the learner's perspective about feedback to tackle the problem of ineffective and inadequate feedback. Learner-centric model tries to understand how learners seek, receive, incorporate, and translate feedback in their learning process.[3]

Last many years have been devoted to the pivotal role of teacher and effective feedback delivering techniques, and little has been devoted to improve the receiving techniques. First and foremost requirement for effective feedback is learner's willingness to improve one's performance. Many studies have shown that self-assessment by learner about their performance may not be accurate, but other studies have shown that the accuracy of self-assessment of learner can be increased.[4],[5] Self-assessment can be improved by observations and suggestions of the educators, building up the culture of informed self-assessment.[6] Educators help the learner to identify the lacunas in their performance by giving their inputs so that learner can reflect on his/her performance and make the self-assessment his performance. However, for this, there has to be institutional culture of feedback which should (a) define the roles of teacher and learner, (b) establish the expectation of feedback process, (c) timing of feedback, and (d) define the performance goals of the learner.

Another important factor in learner-centric model is feedback-seeking behavior. Feedback-seeking behavior can be defined as the conscious devotion of effort toward determining the correctness and adequacy of one's behaviors for attaining valued goals.[7]

Various factors influence residents' feedback-seeking behavior, teacher's receptivity to learner's request, relationship between learner and supervisor, teaching–learning environment, learner's confidence in his/her ability, and extent of contact with feedback deliverer.[8],[9],[10] Actively seeking feedback behavior promotes the self-directed assessment seeking among learners. Learners who actively look to trustworthy educators and peers for inputs on their performance are more receptive to suggestions made by observers.[11]

Learner's emotional reaction to the feedback plays important role on how learner accept given information into self assessment.[12],[13] Learner's self-confidence to admit their mistakes strongly influence his/her receptivity toward feedback.[9] It also depends upon the maturation and development stage of learner. Junior learners value feedback that passively informs them about their progress in meeting the expected level of competency, while more senior learners value feedback that actively guides them in achieving their desired level of competency.[14] This knowledge can help educator, especially in countries such as India where students are comparative young as compared to Western countries.[15]

Another important characteristic of learner that may also impact the effectiveness of feedback is whether the learner is goal oriented or performance oriented. While goal-oriented learner is intrinsically motivated in increasing their competence, performance-oriented students are interested in demonstrating their competence and gathering positive judgment from their teachers.[16] Goal-oriented learners are feedback seekers as they desired to learn more to reach their goals. Many learners are performance oriented rather than goal oriented, and by focusing on ability, intelligence, and grades, we promote performance orientation rather than goal orientation.[17] To promote goal-oriented learning, we need to curb educator habit of promoting performance orientation approach of the learner.

Learner-centric approach works best when the feedback is regular, supportive, from a wide range of reliable and valid external sources with early training about feedback. Early training of residents about feedback helps them to understand about the positive and negative feedback and how to handle their emotions associated with it. Early training period can also help to identify the different personality traits of residents and motivate them toward goal-oriented learning which will make them more receptive to feedback.[18] Residents also should be given tasks to observe the performance of their peers and give feedback to them; it will help them to understand the feedback process and will also motivate to seek feedback from their peers and senior learners also.[19] To promote the culture of effective feedback, it is important that both giver and receiver have to be motivated and early training of the learners will make them more receptive to feedback.


  Strategies For Learner-Centric Feedback Top


  1. Early training program of residents about feedback and methods of delivering feedback
  2. Educate the learner about the emotional response feedback can lead to, and give time to the learner to have self-confidence to receive and incorporate it
  3. Educator should promote feedback seeking behaviour in learners
  4. Individualized and specific feedback to a particular learner
  5. Educators should provide feedback by directly observing learner performance
  6. Institutional feedback culture should be developed which involve learner in planning the timing of feedback and incorporation into their academic routine
  7. Peer feedback should also be a regular part of clinical and bedside training.



  Conclusion Top


Feedback is bidirectional process between the giver and the receivers. Both play an important role to make it effective. In addition, learning environment and emotions can influence the reception of the feedback. Effective feedback is the one which helps the learner to reach the desired level of competency; for this learners have to be receptive. To increase learner receptivity factors that contribute to feedback, receptivity and incorporation need to be developed, evaluated, and implemented.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Gruppen LD. Competency-based education, feedback, and humility. Gastroenterology 2015;148:4-7.  Back to cited text no. 1
    
2.
Jensen AR, Wright AS, Kim S, Horvath KD, Calhoun KE. Educational feedback in the operating room: A gap between resident and faculty perceptions. Am J Surg 2012;204:248-55.  Back to cited text no. 2
    
3.
Archer JC. State of the science in health professional education: Effective feedback. Med Educ 2010;44:101-8.  Back to cited text no. 3
    
4.
Srinivasan M, Hauer KE, Der-Martirosian C, Wilkes M, Gesundheit N. Does feedback matter? Practice-based learning for medical students after a multi-institutional clinical performance examination. Med Educ 2007;41:857-65.  Back to cited text no. 4
    
5.
Sargeant J, Armson H, Chesluk B, Dornan T, Eva K, Holmboe E, et al. The processes and dimensions of informed self-assessment: A conceptual model. Acad Med 2010;85:1212-20.  Back to cited text no. 5
    
6.
Bounds R, Bush C, Aghera A, Rodriguez N, Stansfield RB, Santen SA, et al. Emergency medicine residents' self-assessments play a critical role when receiving feedback. Acad Emerg Med 2013;20:1055-61.  Back to cited text no. 6
    
7.
Milan FB, Dyche L, Fletcher J. How am i doing? Teaching medical students to elicit feedback during their clerkships. Med Teach 2011;33:904-10.  Back to cited text no. 7
    
8.
Bindal T, Wall D, Goodyear HM. Trainee doctors' views on workplace-based assessments: Are they just a tick box exercise? Med Teach 2011;33:919-27.  Back to cited text no. 8
    
9.
Eva KW, Armson H, Holmboe E, Lockyer J, Loney E, Mann K, et al. Factors influencing responsiveness to feedback: On the interplay between fear, confidence, and reasoning processes. Adv Health Sci Educ Theory Pract 2012;17:15-26.  Back to cited text no. 9
    
10.
Delva D, Sargeant J, Miller S, Holland J, Alexiadis Brown P, Leblanc C, et al. Encouraging residents to seek feedback. Med Teach 2013;35:e1625-31.  Back to cited text no. 10
    
11.
Crommelinck M, Anseel F. Understanding and encouraging feedback-seeking behaviour: A literature review. Med Educ 2013;47:232-41.  Back to cited text no. 11
    
12.
Artino AR Jr. When i say emotion in medical education. Med Educ 2013;47:1062-3.  Back to cited text no. 12
    
13.
McConnell MM, Eva KW. The role of emotion in the learning and transfer of clinical skills and knowledge. Acad Med 2012;87:1316-22.  Back to cited text no. 13
    
14.
Murdoch-Eaton D, Sargeant J. Maturational differences in undergraduate medical students' perceptions about feedback. Med Educ 2012;46:711-21.  Back to cited text no. 14
    
15.
Premkumar K, Vinod E, Sathishkumar S, Pulimood AB, Umaefulam V, Samuel P, et al. Self-directed learning readiness of Indian medical students: A mixed method study. BMC Med Educ 2018;18:134.  Back to cited text no. 15
    
16.
Teunissen PW, Stapel DA, van der Vleuten C, Scherpbier A, Boor K, Scheele F, et al. Who wants feedback? An investigation of the variables influencing residents' feedback-seeking behavior in relation to night shifts. Acad Med 2009;84:910-7.  Back to cited text no. 16
    
17.
Elliott ES, Dweck CS. Goals: An approach to motivation and achievement. J Pers Soc Psychol 1988;54:5-12.  Back to cited text no. 17
    
18.
Lefroy J, Watling C, Teunissen PW, Brand P. Guidelines: The do's, don'ts and don't knows of feedback for clinical education. Perspect Med Educ 2015;4:284-99.  Back to cited text no. 18
    
19.
de la Cruz MS, Kopec MT, Wimsatt LA. Resident perceptions of giving and receiving peer-to-peer feedback. J Grad Med Educ 2015;7:208-13.  Back to cited text no. 19
    




 

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