R. Bing-You is professor, Tufts University School of Medicine, Boston, Massachusetts, and vice president for medical education, Maine Medical Center, Portland, Maine. K. Varaklis is clinical associate professor, Tufts University School of Medicine, Boston, Massachusetts, and designated institutional official, Maine Medical Center, Portland, Maine. V. Hayes is clinical assistant professor, Tufts University School of Medicine, Boston, Massachusetts, and faculty member, Department of Family Medicine, Maine Medical Center, Portland, Maine. R. Trowbridge is associate professor, Tufts University School of Medicine, Boston, Massachusetts, and director of undergraduate medical education, Department of Medicine, Maine Medical Center, Portland, Maine. H. Kemp is medical librarian, Maine Medical Center, Portland, Maine. D. McKelvy is manager of library and knowledge services, Maine Medical Center, Portland, Maine.
Acad Med. 2018 Apr;93(4):657-663. doi: 10.1097/ACM.0000000000001927.
To conduct an integrative review and analysis of the literature on the content of feedback to learners in medical education.
Following completion of a scoping review in 2016, the authors analyzed a subset of articles published through 2015 describing the analysis of feedback exchange content in various contexts: audiotapes, clinical examination, feedback cards, multisource feedback, videotapes, and written feedback. Two reviewers extracted data from these articles and identified common themes.
Of the 51 included articles, about half (49%) were published since 2011. Most involved medical students (43%) or residents (43%). A leniency bias was noted in many (37%), as there was frequently reluctance to provide constructive feedback. More than one-quarter (29%) indicated the feedback was low in quality (e.g., too general, limited amount, no action plans). Some (16%) indicated faculty dominated conversations, did not use feedback forms appropriately, or provided inadequate feedback, even after training. Multiple feedback tools were used, with some articles (14%) describing varying degrees of use, completion, or legibility. Some articles (14%) noted the impact of the gender of the feedback provider or learner.
The findings reveal that the exchange of feedback is troubled by low-quality feedback, leniency bias, faculty deficient in feedback competencies, challenges with multiple feedback tools, and gender impacts. Using the tango dance form as a metaphor for this dynamic partnership, the authors recommend ways to improve feedback for teachers and learners willing to partner with each other and engage in the complexities of the feedback exchange.
对医学教育中学习者反馈内容的文献进行综合回顾和分析。
作者在 2016 年完成了一项范围界定审查后,分析了 2015 年之前发表的部分描述了各种情境下反馈交流内容分析的文章:录音带、临床检查、反馈卡、多源反馈、录像带和书面反馈。两位审阅者从这些文章中提取数据并确定了共同的主题。
在 51 篇纳入的文章中,约有一半(49%)是在 2011 年后发表的。大多数涉及医学生(43%)或住院医师(43%)。许多文章都存在宽厚倾向(37%),因为他们常常不愿意提供建设性的反馈。超过四分之一(29%)的文章指出反馈质量较低(例如,过于笼统、数量有限、没有行动计划)。有些(16%)文章指出教师主导了对话,未能正确使用反馈表,或者即使经过培训也提供了不足的反馈。使用了多种反馈工具,有些文章(14%)描述了不同程度的使用、完成或清晰度。有些文章(14%)指出了反馈提供者或学习者的性别对反馈的影响。
研究结果表明,反馈交流受到低质量反馈、宽厚倾向、缺乏反馈能力的教师、多种反馈工具的挑战以及性别影响的困扰。作者采用探戈舞形式来比喻这种动态伙伴关系,建议有意愿相互合作并参与反馈交流复杂性的教师和学习者如何改进反馈。