Department of Medical Education, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
BMC Med Educ. 2021 Jul 12;21(1):382. doi: 10.1186/s12909-021-02722-8.
Face-to-face feedback plays an important role in health professionals' workplace learning. The literature describes guiding principles regarding effective feedback but it is not clear how to enact these. We aimed to create a Feedback Quality Instrument (FQI), underpinned by a social constructivist perspective, to assist educators in collaborating with learners to support learner-centred feedback interactions. In earlier research, we developed a set of observable educator behaviours designed to promote beneficial learner outcomes, supported by published research and expert consensus. This research focused on analysing and refining this provisional instrument, to create the FQI ready-to-use.
We collected videos of authentic face-to-face feedback discussions, involving educators (senior clinicians) and learners (clinicians or students), during routine clinical practice across a major metropolitan hospital network. Quantitative and qualitative analyses of the video data were used to refine the provisional instrument. Raters administered the provisional instrument to systematically analyse educators' feedback practice seen in the videos. This enabled usability testing and resulted in ratings data for psychometric analysis involving multifaceted Rasch model analysis and exploratory factor analysis. Parallel qualitative research of the video transcripts focused on two under-researched areas, psychological safety and evaluative judgement, to provide practical insights for item refinement. The provisional instrument was revised, using an iterative process, incorporating findings from usability testing, psychometric testing and parallel qualitative research and foundational research.
Thirty-six videos involved diverse health professionals across medicine, nursing and physiotherapy. Administering the provisional instrument generated 174 data sets. Following refinements, the FQI contained 25 items, clustered into five domains characterising core concepts underpinning quality feedback: set the scene, analyse performance, plan improvements, foster learner agency, and foster psychological safety.
The FQI describes practical, empirically-informed ways for educators to foster quality, learner-centred feedback discussions. The explicit descriptions offer guidance for educators and provide a foundation for the systematic analysis of the influence of specific educator behaviours on learner outcomes.
面对面的反馈在卫生专业人员的工作场所学习中起着重要作用。文献描述了关于有效反馈的指导原则，但不清楚如何实施这些原则。我们旨在创建一个反馈质量工具（FQI），该工具基于社会建构主义观点，以协助教育者与学习者合作，支持以学习者为中心的反馈互动。在早期的研究中，我们开发了一套可观察的教育者行为，旨在促进有益的学习者成果，这些行为得到了已发表的研究和专家共识的支持。本研究侧重于分析和完善这个临时工具，使其成为可立即使用的 FQI。
我们收集了在一个主要大都市医院网络中进行的常规临床实践中，教育者（高级临床医生）和学习者（临床医生或学生）之间面对面反馈讨论的真实视频。使用视频数据的定量和定性分析来完善临时工具。评分者使用临时工具对视频中观察到的教育者反馈实践进行系统分析。这使得可用性测试成为可能，并产生了用于心理测量分析的评分数据，包括多方面的 Rasch 模型分析和探索性因素分析。对视频记录的平行定性研究侧重于两个研究不足的领域，心理安全性和评价判断，为项目改进提供实际见解。使用迭代过程，结合可用性测试、心理测量测试和并行定性研究以及基础研究的结果，对临时工具进行了修订。
36 个视频涉及医学、护理和物理治疗等不同健康专业人员。使用临时工具生成了 174 个数据集。经过改进，FQI 包含 25 个项目，分为五个领域，这些领域描述了支持质量反馈的核心概念：设置场景、分析表现、计划改进、培养学习者能力和培养心理安全感。
FQI 描述了教育者促进以学习者为中心的高质量反馈讨论的实用、经验丰富的方法。明确的描述为教育者提供了指导，并为系统分析特定教育者行为对学习者成果的影响提供了基础。
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