Medical Students' General Beliefs and Specific Perceptions about Patient Feedback Before and after Training in a Clinical Context

INTRODUCTION: Despite its high potential, patient feedback does not always result in learning. For feedback to be effective students must engage with it, which partly depends on their perceptions of feedback. To better understand student engagement with patient feedback in a clinical context, this study explored the following research questions: 1) What are medical students' general beliefs about patient feedback and what are their specific perceptions of feedback messages? 2) What is the difference between these general beliefs and feedback message perceptions before and after patient feedback training? METHODS: The study context was a 12-week clerkship combining Pediatrics and Gynecology, which included feedback training for students and asking for patient feedback. Ninety 4th-year medical students completed pre- and post-clerkship questionnaires. The questionnaires (Beliefs about Patient Feedback Questionnaire, Feedback Perception Questionnaire) were adapted from validated peer-feedback questionnaires. Questionnaires were quantitatively analyzed. RESULTS: Both pre- and post-clerkship, students had positive general beliefs about patient feedback and positive perceptions of the feedback messages they received. However, paired t-tests showed that students' general beliefs and feedback message perceptions became less positive after feedback training and experience. DISCUSSION: Patient feedback is not an easy means to learn and students do not become feedback literate in terms of patient feedback overnight. We suggest that future researchers further explore reasons for the decline in positive perceptions of patient feedback. We suggest implementing longitudinal feedback training in medical curricula, where students are guided and supported in the complex task of learning from patients through feedback

Peer-instructed seminar attendance is associated with improved preparation, deeper learning and higher exam scores : A survey study

Background: Active engagement in education improves learning outcomes. To enhance active participation in seminars, a student-centered course design was implemented and evaluated in terms of self-reported preparation, student motivation and exam scores. We hypothesized that small group learning with intensive peer interaction, using buzz-groups followed by plenary discussion, would motivate students to prepare seminar assignments at home and to actively engage in the seminars. Active engagement involved discussion of the preparatory assignments until consensus was reached. Methods: In total seven seminars were scheduled in a 10-week physiology course of an undergraduate Biomedical Sciences program. After each seminar, students were asked to fill out their perceptions of preparation and quality of the seminar (deepening of knowledge and confidence in answers) on a five-point scale using electronic questionnaires. Student motives were first collected using open questions. In the final questionnaire students were asked to indicate on a five-point scale how each motive was perceived. Students overall explanations why they had learned from seminars were collected via open questions in the final questionnaire. One hundred and twenty-four students of the cohort from November 2012 to February 2013 (82.6 %) voluntarily participated. Students' motives to prepare and attend seminars were analyzed by inspection of descriptive statistics. Linear regression analysis was conducted to relate student preparation to the quality of seminars, seminar attendance to exam scores, and exam scores to the quality of seminars. Answers to open questions were deductively clustered. Results: Studying the material, training for exams and comparing answers with peers motivated students to prepare the seminars. Students were motivated to participate actively because they wanted to keep track of correct answers themselves, to better understand the content and to be able to present their findings in plenary discussions. Perceived preparation of peers was positively associated with the perceived quality of seminars. Also, seminar attendance was positively associated with exam scores. Students' overall explanations suggest that discussing with peers and applying knowledge in pathophysiology cases underlies this association. Conclusion: Discussion with well-prepared peers during seminars improves student perceptions of deeper learning and peer-instructed seminar attendance was associated with higher exam scores

The relation between feedback perceptions and the supervisor-student relationship in master's thesis projects

Research supervision can be investigated from social-emotional and cognitive perspectives, but most studies include only one perspective. This study aims to understand the interplay between a social-emotional (supervisor-student relationship) and cognitive (feedback) perspective on the outcomes of master's thesis supervision in specific, by investigating student perceptions of both perspectives. Questionnaire data (N = 1016) were collected and analysed using regression analyses. For student satisfaction (SS) and students' perceived supervisor contribution to learning (PSCL), affiliation by far is most important, followed by control for SS and feedback-forward for PSCL. Also, interaction effects between feedback and interpersonal perceptions were found, indicating that the role of feedback perceptions is most important in situations in which no optimal supervisor-student relationship could be established. Findings imply the importance for master's thesis supervisors of creating friendly and helping relationships with students and if this is problematic, extra care should be taken with giving feedback

The relation between feedback perceptions and the supervisor-student relationship in master's thesis projects

Research supervision can be investigated from social-emotional and cognitive perspectives, but most studies include only one perspective. This study aims to understand the interplay between a social-emotional (supervisor-student relationship) and cognitive (feedback) perspective on the outcomes of master's thesis supervision in specific, by investigating student perceptions of both perspectives. Questionnaire data (N = 1016) were collected and analysed using regression analyses. For student satisfaction (SS) and students' perceived supervisor contribution to learning (PSCL), affiliation by far is most important, followed by control for SS and feedback-forward for PSCL. Also, interaction effects between feedback and interpersonal perceptions were found, indicating that the role of feedback perceptions is most important in situations in which no optimal supervisor-student relationship could be established. Findings imply the importance for master's thesis supervisors of creating friendly and helping relationships with students and if this is problematic, extra care should be taken with giving feedback

Adaptive research supervision: Exploring expert thesis supervisors' practical knowledge

Several researchers have suggested the importance of being responsive to students' needs in research supervision. Adapting support strategies to students' needs in light of the goals of a task is referred to as adaptivity. In the present study, the practice of adaptivity is explored by interviewing expert thesis supervisors about diagnosing student characteristics in order to determine students' needs and concurrent adaptive support strategies. The findings suggest that next to competence, supervisors also diagnose elements of students' determination and context. With respect to support strategies, it is suggested that supervisors adapt to student needs in terms of explicating standards, quality or consequences, division of responsibilities, providing more/less critical feedback and sympathising. The complexity of the relationship between diagnosing student characteristics and adapting support strategies is illustrated and needs further study

Understanding the up, back, and forward-component in master's thesis supervision with adaptivity

Despite the importance of goals in educational theories, goals in master's thesis projects are rarely investigated. Therefore, this study explores how goals play a role in master's thesis supervision in terms of: defining the goals (up-component); locating where the student stands in relation to the goals (back-component); and how the student can more closely reach the goals (forward-component). Twelve supervisors and students were interviewed and the adaptive approach of supervision emerged as a recurrent theme. Applying qualitative content analysis, findings indicated that the role of goals can be described as: aiming to reach the goals (up-component) by adapting supervision strategies (forward-component), based on students' specific needs and where they stand (back-component). This was termed ‘adaptivity’. Providing adaptive supervision can also involve tensions concerning the level of regulation and the severity of their critique (ranging from mild to heavy-handed). Findings are discussed in relation to other studies concerning research supervision

Students generate items for an online formative assessment : Is it motivating?

Background: A reported problem with e-learning is sustaining students’ motivation. We propose a framework explaining to what extent an e-learning task is motivating. This framework includes students’ perceived Value of the task, Competence in executing the task, Autonomy over how to carry out the task, and Relatedness. Methods: To test this framework, students generated items in an online environment and answered questions developed by their fellow students. Motivation was measured by analyzing engagement with the task, with an open-ended questionnaire about engagement, and with the motivated strategies for learning questionnaire (MSLQ). Results: Students developed 59 questions and answered 1776 times on the questions. Differences between students who did or did not engage in the task are explained by the degree of self-regulation, time management, and effort regulation students report. There was a significant relationship between student engagement and achievement after controlling for previous academic achievement. Conclusions: This study proposes a way of explaining the motivational value of an e-learning task by looking at students’ perceived competence, autonomy, value of the task, and relatedness. Student-generated items are considered of high task value, and help to perceive relatedness between students. With the right instruction, students feel competent to engage in the task