Department of Medical Education and Faculty Development, Isala Hospital, Isala Academy, Zwolle, The Netherlands.
Lifelong Learning, Education and Assessment Research Network (LEARN), University Medical Centre Groningen, Groningen, The Netherlands.
Perspect Med Educ. 2021 Jan;10(1):50-56. doi: 10.1007/s40037-020-00617-w.
Although there is consensus in the medical education world that feedback is an important and effective tool to support experiential workplace-based learning, learners tend to avoid the feedback associated with direct observation because they perceive it as a high-stakes evaluation with significant consequences for their future. The perceived dominance of the summative assessment paradigm throughout medical education reduces learners' willingness to seek feedback, and encourages supervisors to mix up feedback with provision of 'objective' grades or pass/fail marks. This eye-opener article argues that the provision and reception of effective feedback by clinical supervisors and their learners is dependent on both parties' awareness of the important distinction between feedback used in coaching towards growth and development (assessment for learning) and reaching a high-stakes judgement on the learner's competence and fitness for practice (assessment of learning). Using driving lessons and the driving test as a metaphor for feedback and assessment helps supervisors and learners to understand this crucial difference and to act upon it. It is the supervisor's responsibility to ensure that supervisor and learner achieve a clear mutual understanding of the purpose of each interaction (i.e. feedback or assessment). To allow supervisors to use the driving lesson-driving test metaphor for this purpose in their interactions with learners, it should be included in faculty development initiatives, along with a discussion of the key importance of separating feedback from assessment, to promote a feedback culture of growth and support programmatic assessment of competence.
虽然医学教育界普遍认为反馈是支持基于经验的职场学习的重要且有效的工具，但学习者往往回避与直接观察相关的反馈，因为他们认为这是一种高风险的评估，对他们的未来有重大影响。整个医学教育中总结性评估范式的主导地位降低了学习者寻求反馈的意愿，并鼓励主管人员将反馈与提供“客观”成绩或通过/失败标记混合在一起。这篇发人深省的文章认为，临床主管人员及其学习者提供和接收有效反馈的能力取决于双方都意识到在用于促进成长和发展的指导中的反馈（学习评估）与对学习者的能力和实践适合性的高风险判断（学习评估）之间的重要区别。使用驾驶课程和驾驶考试作为反馈和评估的隐喻，可以帮助主管人员和学习者理解这一关键区别，并据此采取行动。主管人员有责任确保主管人员和学习者对每次互动的目的（即反馈或评估）有明确的共同理解。为了允许主管人员在与学习者的互动中使用驾驶课-驾驶考试的隐喻，应该将其纳入教师发展计划中，并讨论将反馈与评估分开的关键重要性，以促进成长的反馈文化，并支持能力的计划评估。
