Griffiths Leonie, Hilder Joanne, Molloy Elizabeth, Ryan Anna, Watling Christopher
The University of Melbourne, AU.
Southern Cross University, AU.
Perspect Med Educ. 2025 Sep 1;14(1):519-530. doi: 10.5334/pme.1689. eCollection 2025.
Learners' experiences of feedback conversations, and their longitudinal impact, are largely invisible to educators. While we know more about what makes for an effective feedback conversation, we are yet to fully understand how learners make sense of these encounters over time. This has implications for understanding the potency of feedback on practice and for how best to support learners, particularly when the experience is challenging. Our research aimed to explore the characteristics of difficult feedback and the temporal aspects of feedback sensemaking.
We collected written narratives from 32 doctors and 49 medical students via an online questionnaire about a time when they received difficult feedback in a clinical setting. Open- ended prompts facilitated participants to describe their experience, the evaluation of it over time, and the learning that arose from it. We undertook reflexive thematic analysis of the data, informed by constructivist sensemaking perspectives.
Difficult feedback conversations were characterized by unpredictable and complex interactions between emotions, sensemaking and learning. Despite some feedback perceived as personal, inappropriate, or threatening, feedback information was seldom disregarded. Participants engaged in feedback sharing and reflection, which often extended over years, contributing to identity work and to development of their clinical practice.
Our findings highlighted the temporal nature of sensemaking of difficult feedback and challenge expectations for learners to respond and commit to progress in the moment. Providing learners with time for reflection on feedback and opportunities to connect with personal and professional networks may facilitate the longitudinal sensemaking processes.
教育工作者很大程度上看不到学习者在反馈对话中的经历及其长期影响。虽然我们对促成有效反馈对话的因素了解得更多，但我们尚未完全理解学习者如何随着时间的推移理解这些交流。这对于理解反馈对实践的效力以及如何最好地支持学习者具有重要意义，尤其是当经历具有挑战性时。我们的研究旨在探索困难反馈的特征以及反馈意义建构的时间维度。
我们通过在线问卷收集了32名医生和49名医学生关于他们在临床环境中收到困难反馈的一次经历的书面叙述。开放式提示促使参与者描述他们的经历、对其随时间的评价以及从中产生的学习。我们以建构主义意义建构视角为指导，对数据进行了反思性主题分析。
困难反馈对话的特点是情绪、意义建构和学习之间存在不可预测且复杂的相互作用。尽管有些反馈被认为是针对个人的、不恰当的或具有威胁性的，但反馈信息很少被忽视。参与者进行了反馈分享和反思，这通常会持续数年，有助于身份认同工作和临床实践的发展。
我们的研究结果突出了困难反馈意义建构的时间性质，并对学习者当下做出回应并致力于进步的期望提出了挑战。为学习者提供反思反馈的时间以及与个人和专业网络建立联系的机会，可能会促进长期的意义建构过程。
