Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
BMC Med Educ. 2022 May 25;22(1):401. doi: 10.1186/s12909-022-03468-7.
In medical students' workplace learning, feedback is important for effective learning regarding communication and clinical skills. The provision of multisource feedback (MSF) in clinical practice with focus on the patient's perspective is rarely addressed in the literature. The overall objective was to explore the experience of MSF in medical students' clinical learning in primary healthcare (PHC).
In the study, patients provided feedback by use of the Patient Feedback in Clinical Practice (PFCP) questionnaire. By use of adapted PFCP questionnaire versions peers and clinical supervisors provided feedback and students performed a self-evaluation. The MSF learning activity was evaluated using surveys (4-point Likert scale/open-ended questions), (students (n = 26), peers (n = 9) and clinical supervisors (n = 7)). Data were analysed using descriptive and qualitative content analysis.
Results (mean 4-point Likert scale) from participants evaluation of the MSF learning activity visualises the value of feedback in terms of patient-centred communication (students 3.50, peers 2.44 and clinical supervisors 3.57), guidance for further training (students 3.14, peers 2.89 and clinical supervisors 3.00) and clarification of pedagogical assignment (students 3.14, peers 2.89 and clinical supervisors 3.00). Thematic analysis of participants' free-text answers in the evaluation surveys resulted in three themes: (1) applicability of the MSF, (2) MSF - collaborative learning process and (3) MSF as a facilitator in students' clinical skills development. The participants experienced that the written MSF provided multi-facetted perspectives, which contributed to students' and peers' clinical and communication learning. MSF experience also enhanced clinical supervisors' feedback regarding communication skills, targeting the supervisors' pedagogical assignment.
Our findings indicate that MSF provided directly after a patient encounter, using the PFCP questionnaire as feedback provider, could be an adequate learning activity for medical students' workplace learning. The MSF, provided through the PFCP questionnaire, was experienced to neutralise and operationalise the provision of concrete feedback, facilitating peers' learning and clinical supervisors' tuition. The results visualise the importance of patients in MSF, as a valuable resource in students' workplace learning. Our study implies that this learning activity could be an applicable tool to facilitate learning and pedagogic development in clinical education in PHC.
在医学生的工作场所学习中，反馈对于沟通和临床技能的有效学习非常重要。然而，文献中很少涉及在临床实践中提供多源反馈（MSF），并重点关注患者视角。本研究的总体目标是探讨 MSF 在医学生在初级保健（PHC）中的临床学习中的体验。
在这项研究中，患者使用患者临床实践反馈（PFCP）问卷提供反馈。通过使用改编后的 PFCP 问卷版本，同伴和临床主管提供反馈，学生进行自我评估。使用调查（4 分李克特量表/开放式问题）评估 MSF 学习活动（学生（n=26）、同伴（n=9）和临床主管（n=7））。使用描述性和定性内容分析对数据进行分析。
参与者对 MSF 学习活动的评估结果（平均 4 分李克特量表）以患者为中心的沟通（学生 3.50、同伴 2.44 和临床主管 3.57）、进一步培训指导（学生 3.14、同伴 2.89 和临床主管 3.00）和教学任务澄清（学生 3.14、同伴 2.89 和临床主管 3.00）方面体现了反馈的价值。对评估调查中参与者自由文本回答的主题分析产生了三个主题：（1）MSF 的适用性，（2）MSF-协作学习过程，（3）MSF 作为学生临床技能发展的促进者。参与者体验到书面 MSF 提供了多方面的观点，这有助于学生和同伴的临床和沟通学习。MSF 经验还增强了临床主管对沟通技能的反馈，针对主管的教学任务。
我们的研究结果表明，在初级保健中，在与患者接触后直接使用 PFCP 问卷作为反馈提供者提供 MSF，可以成为医学生工作场所学习的有效学习活动。通过 PFCP 问卷提供的 MSF，被经验证明可以中和和操作具体反馈的提供，促进同伴学习和临床主管的教学。结果说明了患者在 MSF 中的重要性，这是学生工作场所学习的宝贵资源。我们的研究表明，这种学习活动可能是促进临床教育中学习和教学发展的一种适用工具。
