Matthews Andrew, Hall Matthew, Parra Jose M, Hayes Margaret M, Beltran Christine P, Ranchoff Brittany L, Sullivan Amy M, William Jeffrey H
Perelman School of Medicine, University of Pennsylvania Health Systems, Department of Medicine, Philadelphia, PA, USA.
Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Adv Med Educ Pract. 2020 Nov 12;11:861-867. doi: 10.2147/AMEP.S271623. eCollection 2020.
Many programs designed to improve feedback to students focus on faculty's ability to provide a safe learning environment, and specific, actionable suggestions for improvement. Little attention has been paid to improving students' attitudes and skills in accepting and responding to feedback effectively. Effective "real-time" feedback in the clinical setting is dependent on both the skill of the teacher and the learner's ability to receive the feedback. Medical students entering their clinical clerkships are not formally trained in receiving feedback, despite the significant amount of feedback received during this time.
We developed and implemented a one-hour workshop to teach medical students strategies for effectively receiving and responding to "real-time" (formative) feedback in the clinical environment. Subjective confidence and skill in receiving real-time feedback were assessed in pre- and post-workshop surveys. Objective performance of receiving feedback was evaluated before and after the workshop using a simulated feedback encounter designed to re-create common clinical and cognitive pitfalls for medical students, called an objective structured teaching exercise (OSTE).
After a single workshop, students self-reported increased confidence (mean 6.0 to 7.4 out of 10, <0.01) and skill (mean 6.0 to 7.0 out of 10, =0.10). Compared to pre-workshop OSTE scores, post-workshop OSTE scores objectively measuring skill in receiving feedback were also significantly higher (mean 28.8 to 34.5 out of 40, =0.0131).
A one-hour workshop dedicated to strategies in receiving real-time feedback may improve effective feedback reception as well as self-perceived skill and confidence in receiving feedback. Providing strategies to trainees to improve their ability to effectively receive feedback may be a high-yield approach to both strengthen the power of feedback in the clinical environment and enrich the clinical experience of the medical student.
许多旨在改善对学生反馈的项目都聚焦于教师营造安全学习环境的能力，以及提供具体、可操作的改进建议。而对于提高学生有效接受和回应反馈的态度与技能却鲜有关注。临床环境中的有效“实时”反馈既取决于教师的技巧，也依赖于学习者接受反馈的能力。尽管医学生在临床实习期间会收到大量反馈，但他们并未接受过关于接受反馈的正规培训。
我们开发并实施了一个一小时的工作坊，教授医学生在临床环境中有效接受和回应“实时”（形成性）反馈的策略。通过工作坊前后的调查评估学生接受实时反馈的主观信心和技能。使用模拟反馈环节对接受反馈的客观表现进行评估，该模拟环节旨在重现医学生常见的临床和认知陷阱，即客观结构化教学练习（OSTE），分别在工作坊前后进行。
经过一次工作坊后，学生自我报告称信心增强（平均从10分制的6.0分提高到7.4分，<0.01），技能提高（平均从10分制的6.0分提高到7.0分，=0.10）。与工作坊前的OSTE分数相比，工作坊后客观测量接受反馈技能的OSTE分数也显著更高（平均从40分制的28.8分提高到34.5分，=0.0131）。
一个专注于接受实时反馈策略的一小时工作坊可能会提高有效反馈接收能力，以及接受反馈的自我感知技能和信心。为学员提供提高其有效接受反馈能力的策略，可能是一种既能增强临床环境中反馈的作用，又能丰富医学生临床经验的高效方法。
