在真实临床实践环境中反馈时教育者的行为：一项观察性研究和系统分析。
Educators' behaviours during feedback in authentic clinical practice settings: an observational study and systematic analysis.
机构信息
Monash Doctors Education, Monash Health and Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, Australia.
出版信息
BMC Med Educ. 2019 May 2;19(1):129. doi: 10.1186/s12909-019-1524-z.
BACKGROUND
Verbal feedback plays a critical role in health professions education but it is not clear which components of effective feedback have been successfully translated from the literature into supervisory practice in the workplace, and which have not. The purpose of this study was to observe and systematically analyse educators' behaviours during authentic feedback episodes in contemporary clinical practice.
METHODS
Educators and learners videoed themselves during formal feedback sessions in routine hospital training. Researchers compared educators' practice to a published set of 25 educator behaviours recommended for quality feedback. Individual educator behaviours were rated 0 = not seen, 1 = done somewhat, 2 = consistently done. To characterise individual educator's practice, their behaviour scores were summed. To describe how commonly each behaviour was observed across all the videos, mean scores were calculated.
RESULTS
Researchers analysed 36 videos involving 34 educators (26 medical, 4 nursing, 4 physiotherapy professionals) and 35 learners across different health professions, specialties, levels of experience and gender. There was considerable variation in both educators' feedback practices, indicated by total scores for individual educators ranging from 5.7 to 34.2 (maximum possible 48), and how frequently specific feedback behaviours were seen across all the videos, indicated by mean scores for each behaviour ranging from 0.1 to 1.75 (maximum possible 2). Educators commonly provided performance analysis, described how the task should be performed, and were respectful and supportive. However a number of recommended feedback behaviours were rarely seen, such as clarifying the session purpose and expectations, promoting learner involvement, creating an action plan or arranging a subsequent review.
CONCLUSIONS
These findings clarify contemporary feedback practice and inform the design of educational initiatives to help health professional educators and learners to better realise the potential of feedback.
背景
口头反馈在健康专业教育中起着至关重要的作用，但目前尚不清楚文献中哪些有效的反馈要素已经成功地从理论转化为工作场所中的监督实践，哪些没有。本研究的目的是观察和系统分析教育者在当代临床实践中的真实反馈事件中的行为。
方法
教育者和学习者在常规医院培训的正式反馈会议期间对自己进行录像。研究人员将教育者的实践与已发表的 25 项教育者行为建议进行了比较，这些行为建议是为了提供高质量的反馈。对每个行为的评价分为 0（未观察到）、1（略有观察到）和 2（一致观察到）。为了描述个体教育者的实践，对他们的行为得分进行了求和。为了描述所有视频中观察到的每个行为的频率，计算了平均值。
结果
研究人员分析了 36 个视频，涉及 34 名教育者（26 名医学、4 名护理、4 名物理治疗专业人员）和 35 名来自不同健康专业、专业、经验水平和性别的学习者。教育者的反馈实践存在很大差异，个体教育者的总得分从 5.7 到 34.2 不等（最高得分为 48），而在所有视频中观察到的特定反馈行为的频率则通过每个行为的平均得分（最高得分为 2）来表示。教育者通常提供绩效分析、描述任务应该如何执行，并且尊重和支持学习者。然而，一些推荐的反馈行为很少见，例如澄清会议目的和期望、促进学习者参与、制定行动计划或安排后续审查。
结论
这些发现阐明了当代反馈实践，并为设计教育计划提供了信息，以帮助健康专业教育者和学习者更好地实现反馈的潜力。
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