M. Bearman is research professor, Centre for Research in Assessment and Digital Learning, Deakin University, Melbourne, Australia; ORCID: https://orcid.org/0000-0002-6862-9871 .
J. Brown is a medical practitioner, supervisor, and principal medical education advisor, Royal Australian College of General Practitioners, Melbourne, Australia, and a PhD candidate, Monash University, Melbourne, Australia; ORCID: https://orcid.org/0000-0002-7262-1629 .
Acad Med. 2021 Feb 1;96(2):205-209. doi: 10.1097/ACM.0000000000003716.
Feedback pedagogies and research tend to focus on immediate corrective actions rather than learning for the longer term. This approach means that feedback may not support trainees who are managing complex, competing, and ambiguous practice situations, often with limited supervision. There is an opportunity to consider how feedback can help medical trainees sustain their own development into the future, including when they have completed formal training. This article explores how feedback pedagogies can facilitate medical trainees' abilities to develop challenging aspects of practice across multiple clinical environments to eventually practice without supervision. From a sociocultural perspective, clinical training takes place within a practice curriculum; each clinical environment offers varying opportunities, which the trainees may choose to engage with. The authors propose feedback as an interpersonal process that helps trainees make sense of both formal training requirements and performance relevant information, including workplace cues such as patient outcomes or colleagues' comments, found within any practice curriculum. A significant pedagogic strategy may be to develop trainees' evaluative judgment or their capability to identify and appraise the qualities of good practice in both themselves and others. In this way, feedback processes may help trainees surmount complex situations and progressively gain independence from supervision.
反馈教学法和研究往往侧重于即时纠正措施，而不是着眼于长期学习。这种方法意味着反馈可能无法为那些正在管理复杂、竞争激烈和模糊的实践情况的受训者提供支持，他们通常在监督有限的情况下工作。现在有机会考虑一下反馈如何能够帮助医学受训者在未来维持自身的发展，包括在他们完成正式培训之后。本文探讨了反馈教学法如何能够帮助医学受训者发展在多个临床环境中实践的具有挑战性的方面的能力，最终实现无需监督的实践。从社会文化的角度来看，临床培训是在实践课程中进行的；每个临床环境都提供了不同的机会，受训者可以选择参与其中。作者提出反馈是一种人际过程，可以帮助受训者理解正式培训要求和与绩效相关的信息，包括工作场所的线索，如患者的结果或同事的意见，这些都存在于任何实践课程中。一个重要的教学策略可能是培养受训者的评价判断能力，或他们识别和评估自身和他人良好实践品质的能力。通过这种方式，反馈过程可以帮助受训者克服复杂的情况，并逐步从监督中获得独立。
