Robb Katharine A, Rosenbaum Marcy E, Peters Lauren, Lenoch Susan, Lancianese Donna, Miller Jane L
K.A. Robb is clinical assistant professor, Department of Pediatrics, Division of Critical Care, University of Iowa Carver College of Medicine, Iowa City, Iowa; ORCID: http://orcid.org/0000-0002-3071-3429 .
M.E. Rosenbaum is professor, Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa; ORCID: http://orcid.org/0000-0002-8000-5711 .
Acad Med. 2023 Feb 1;98(2):248-254. doi: 10.1097/ACM.0000000000004917. Epub 2022 Aug 9.
Learner-centered feedback models encourage educators to ask learners to self-assess at the start of feedback conversations. This study examines how learners perceive and respond to self-assessment prompts during feedback conversations and assesses medical students' perceptions of and approach to self-assessment used as the basis for these conversations.
All rising second-, third-, and fourth-year medical students at a midwestern U.S. medical school were invited to participate in this study. Students participated in 1-on-1 interviews between June and August 2019 during which they were asked open-ended questions about their experiences with self-assessment and feedback during medical school. The interviews were audio recorded and transcribed, and comments related to self-assessment in feedback conversations were extracted. Thematic analysis was used to identify recurrent ideas and patterns within the transcripts, and all excerpts were reviewed and coded to ensure that the identified themes adequately captured the range of student responses.
A total of 25 students participated in the study. Although some students noted improvement in their self-assessment abilities with increasing experience, no consistent gender, race, or training-level differences were found in reported attitudes or preferences. Students identified many benefits of self-assessment and generally appreciated being asked to self-assess before receiving feedback. Students had varied responses to specific self-assessment prompts, with no clear preferences for any particular self-assessment questions. Students described weighing multiple factors, such as image concerns and worries about impact on subsequent evaluations, when deciding how to respond to self-assessment prompts.
The process by which learners formulate and share self-assessments in feedback conversations is not straightforward. Although educators should continue to elicit self-assessments in feedback discussions, they should recognize the limitations of these self-assessments and strive to create a safe environment in which learners feel empowered to share their true impressions.
以学习者为中心的反馈模式鼓励教育工作者在反馈对话开始时要求学习者进行自我评估。本研究探讨学习者在反馈对话中如何看待和回应自我评估提示，并评估医学生对用作这些对话基础的自我评估的看法和方法。
邀请美国中西部一所医学院所有即将升入大二、大三和大四的医学生参与本研究。学生们在2019年6月至8月期间参加了一对一访谈，访谈中他们被问及关于医学院期间自我评估和反馈经历的开放式问题。访谈进行了录音和转录，并提取了与反馈对话中自我评估相关的评论。采用主题分析法识别转录文本中反复出现的观点和模式，所有摘录都经过审查和编码，以确保所确定的主题充分涵盖学生回答的范围。
共有25名学生参与了该研究。尽管一些学生指出随着经验的增加，他们的自我评估能力有所提高，但在报告的态度或偏好方面，未发现一致的性别、种族或培训水平差异。学生们指出了自我评估的许多好处，并且普遍赞赏在收到反馈之前被要求进行自我评估。学生们对特定的自我评估提示有不同的反应，对任何特定的自我评估问题没有明确的偏好。学生们描述了在决定如何回应自我评估提示时会权衡多个因素，如形象问题和担心对后续评估的影响。
学习者在反馈对话中制定和分享自我评估的过程并不简单。尽管教育工作者应继续在反馈讨论中引导学生进行自我评估，但他们应认识到这些自我评估的局限性，并努力营造一个让学习者感到有能力分享其真实印象的安全环境。
