Hillingdon Hospital, Pield Heath Road, Uxbridge, UB8 3NN, UK.
Imperial College London, London, UK.
BMC Med Educ. 2017 Sep 29;17(1):179. doi: 10.1186/s12909-017-1017-x.
High quality feedback is vital to learning in medical education but many students and teachers have expressed dissatisfaction on current feedback practices. Lack of teachers' insight into students' feedback requirements may be a key, which might be addressed by giving control to the students with student led feedback practices. The conceptual framework was built on three dimensions of learning theory by Illeris and Vygotsky's zone of proximal development and scaffolding. We introduced a feedback session with self-reflection and peer feedback in the form of open discussion on video-recorded student performances under teacher's guidance. The aims of this qualitative study were to explore students' perception on this holistic feedback approach and to investigate ways of maximising effective feedback and learning.
Semi-structured interviews were used to gather data which were evaluated using a thematic analytical approach. The participants were third year medical students of Imperial College London on clinical placements at Hillingdon Hospital.
Video based self-reflection helped some students to identify mistakes in communication and technical skills of which they were unaware prior to the session. Those who were new to video feedback found their expected self-image different to that of their actual image on video, leading to some distress. However many also identified that mistakes were not unique to themselves through peer videos and learnt from both model performances and from each other's mistakes. Balancing honest feedback with empathy was a challenge for many during peer discussion. The teacher played a vital role in making the session a success by providing guidance and a supportive environment.
This study has demonstrated many potential benefits of this holistic feedback approach with video based self-reflection and peer discussion with students engaging at a deeper cognitive level than the standard descriptive feedback.
高质量的反馈对于医学教育中的学习至关重要,但许多学生和教师对当前的反馈实践表示不满。教师对学生反馈需求的洞察力不足可能是一个关键问题,可以通过让学生主导反馈实践来解决。该概念框架建立在 Illeris 和 Vygotsky 的学习理论的三个维度以及最近发展区和支架的基础上。我们在教师的指导下,引入了一个带有自我反思和同伴反馈的反馈环节,以视频记录的学生表现进行开放式讨论的形式进行。本定性研究的目的是探讨学生对这种整体反馈方法的看法,并研究最大限度地提高有效反馈和学习的方法。
采用半结构化访谈收集数据,采用主题分析方法进行评估。参与者是伦敦帝国理工学院三年级的医学生,在希灵登医院进行临床实习。
基于视频的自我反思帮助一些学生识别出了沟通和技术技能方面的错误,而这些错误在反馈之前他们并不知道。那些对视频反馈不熟悉的学生发现他们在视频中的预期自我形象与实际形象不同,这让他们感到有些痛苦。然而,许多学生也通过同伴的视频认识到,错误并不是他们独有的,他们从模范表现和彼此的错误中都有所学习。在同伴讨论中,平衡诚实的反馈和同理心是许多人面临的挑战。教师通过提供指导和支持性环境,在使课程取得成功方面发挥了至关重要的作用。
本研究表明,这种整体反馈方法具有许多潜在的好处,包括基于视频的自我反思和同伴讨论,学生的参与度达到了比标准描述性反馈更深的认知水平。