Ryan Anna, McColl Geoffrey J, O'Brien Richard, Chiavaroli Neville, Judd Terry, Finch Sue, Swanson David
Department of Medical Education, University of Melbourne, Melbourne, Victoria, Australia.
Statistical Consulting Centre, University of Melbourne, Melbourne, Victoria, Australia.
Med Educ. 2017 Sep;51(9):963-973. doi: 10.1111/medu.13366.
Self-regulation is recognised as being a requisite skill for professional practice This study is part of a programme of research designed to explore efficient methods of feedback that improve medical students' ability to self-regulate their learning. Our aim was to clarify how students respond to different forms and content of written feedback and to explore the impact on study behaviour and knowledge acquisition.
Year 2 students in a 4-year graduate entry medical programme completing four formative progress tests during the academic year were randomised into three groups receiving different feedback reports. All reports included proportion correct overall and by clinical rotation. One group received feedback reports including lists of clinical presentations relating to questions answered correctly and incorrectly; another group received reports containing this same information in combination with response certitude. The final group received reports involving normative comparisons. Baseline progress test performance quartile groupings (a proxy for academic ability) were determined by results on the first progress test. A mixed-method approach with triangulation of research findings was used to interpret results. Outcomes of interest included progress test scores, summative examination results and measures derived from study diaries, questionnaires and semi-structured interviews.
Of the three types of feedback provided in this experiment, feedback containing normative comparisons resulted in inferior test performance for students in the lowest performance quartile group. This type of feedback appeared to stimulate general rather than examination-focused study.
Medical students are often considered relatively homogenous and high achieving, yet the results of this study suggest caution when providing them with normative feedback indicating poorer performance relative to their peers. There is much need for further work to explore efficient methods of providing written feedback that improves medical students' ability to self-regulate their learning, particularly when giving feedback to those students who have the most room for improvement.
自我调节被认为是专业实践所需的一项技能。本研究是一项研究计划的一部分，该计划旨在探索能提高医学生自我调节学习能力的有效反馈方法。我们的目的是阐明学生如何对不同形式和内容的书面反馈做出反应，并探讨其对学习行为和知识获取的影响。
在一个为期4年的研究生入学医学课程中，二年级学生在学年期间完成了四次形成性进度测试，他们被随机分为三组，分别收到不同的反馈报告。所有报告都包括总体正确比例以及按临床轮转划分的正确比例。一组收到的反馈报告包括与正确和错误回答问题相关的临床表现列表；另一组收到的报告包含相同信息以及回答的确信度。最后一组收到的报告涉及规范性比较。根据第一次进度测试的结果确定基线进度测试成绩四分位数分组（作为学术能力的替代指标）。采用混合方法并对研究结果进行三角验证来解释结果。感兴趣的结果包括进度测试分数、总结性考试成绩以及从学习日记、问卷和半结构化访谈中得出的指标。
在本实验提供的三种反馈类型中，包含规范性比较的反馈导致成绩最低的四分位数组学生的测试表现较差。这种反馈似乎激发了一般性学习而非专注于考试的学习。
医学生通常被认为相对同质化且成绩优异，但本研究结果表明，在向他们提供表明其相对于同龄人表现较差的规范性反馈时需谨慎。非常需要进一步开展工作，以探索能提高医学生自我调节学习能力的有效书面反馈方法，特别是在向那些有最大改进空间的学生提供反馈时。
