Universitätsklinikum Tübingen, Institute for General Practice and Interprofessional Health Care, Tübingen, Germany.
Med Educ Online. 2022 Dec;27(1):2077687. doi: 10.1080/10872981.2022.2077687.
Feedback is an important aspect of teaching and learning in medical education. Irrespective of the training environment, too little effective dialogic feedback occurs. Community-based outpatient learning environments, such as general practitioner practices, have heterogeneous framework conditions regarding feedback that decrease feedback quality. To improve feedback in this setting, characteristics of feedback in such learning environments must be considered. This study aims to reveal such characteristics from different perspectives and derive ideas for improving feedback in community-based learning environments. Three stakeholder groups in family medicine clerkships as an example of community-based learning environments (n = 15 students, n = 12 faculty and administrative staff, n = 13 general physician trainers) were interviewed for this study. Transcripts of the interviews were analysed with qualitative content analysis. All stakeholders interviewed note a lack of feedback between groups. Feedback in primary care practices takes place in specific contexts (e.g., during vs after a consultation, during vs at the end of the clerkship) and is provided in different ways (e.g., verbal vs nonverbal). Barriers of effective feedback in community-based settings are: lack of opportunity/initiation, fear of giving feedback, unawareness (of correct feedback and/or lack of prior experience with feedback), and little basis for feedback. Currently, the exchange between the university and community-based learning environments is limited to grading and report writing, with little sharing of meaningful information. The potential of a better exchange between those within community-based learning environments and the university to improve feedback processes is not reached. This exchange and the framework conditions specific for the community-based learning environment should be considered as parts of the structural dimension of feedback. Teachers and course managers of family medicine institutes are in an important position to shape these factors actively, working together with stakeholders of community-based teaching.
反馈是医学教育中教学和学习的一个重要方面。无论培训环境如何，有效的对话式反馈都太少了。以全科医生诊所为例的社区门诊学习环境，其反馈的框架条件存在异质性，这会降低反馈质量。为了在这种环境中改进反馈，必须考虑这种学习环境中反馈的特点。本研究旨在从不同角度揭示这些特点，并为改进社区学习环境中的反馈提供思路。本研究采访了家庭医学实习中的三个利益相关者群体（n=15 名学生、n=12 名教职员工和行政人员、n=13 名全科医生培训师）作为社区学习环境的示例。对采访的文字记录进行了定性内容分析。所有接受采访的利益相关者都注意到群体之间缺乏反馈。初级保健实践中的反馈发生在特定的背景下（例如，在咨询期间与之后、在实习期间与结束时），并以不同的方式提供（例如，口头与非口头）。社区环境中有效反馈的障碍包括：缺乏机会/主动性、害怕提供反馈、缺乏意识（正确的反馈和/或缺乏反馈经验），以及反馈的基础很少。目前，大学和社区学习环境之间的交流仅限于评分和报告撰写，很少有有意义的信息共享。社区学习环境中那些人之间以及与大学之间更好的交流潜力尚未得到充分发挥，以改善反馈过程。这种交流以及社区学习环境特有的框架条件应被视为反馈的结构性维度的一部分。家庭医学研究所的教师和课程管理人员处于积极塑造这些因素的重要地位，与社区教学的利益相关者合作。
