Integrating 360° behavior-orientated feedback in communication skills training for medical undergraduates: concept, acceptance and students’ self-ratings of communication competence

BACKGROUND: Feedback is considered a key didactic element in medical education, especially for teaching of communication skills. This study investigates the impact of a best evidence-based practice feedback concept within the context of communication skills training (CST). We evaluate this concept for acceptance and changes in students self-ratings of communication competence. METHODS: Our CST integrating feedback process comprises a short theoretical introduction presenting standards for good communication and a constructive 360° feedback from three perspectives: feedback from peers, from standardized patients (SPs), and from a trainer. Feed-forward process was facilitated for documenting suggestions for improvements based on observable behaviors to maximize learning benefits. Our CST was applied to four groups of eight or nine students. We assessed the data on students’ acceptance using a 6-point scale ranging from very good (1) to poor (6), applied a forced choice question to rank didactic items, and assessed changes in student’ self-ratings of their communication competence on a 10-cm visual analogue scale (VAS). RESULTS: Thirty-four medical undergraduates (82 % female, 18 % male) in their first clinical year, with an average age of 21.4 years (SD = 1.0), participated in the new training. The concept achieved high acceptance from good to very good: overall impression (M = 1.56), sufficient interaction for discussion (M = 1.15), and constructive learning atmosphere (M = 1.18). Specific elements, such as practical training with SPs (M = 1.18) and feedback by SPs (M = 1.12), showed highest acceptance. The forced choice ranking placed all feedback elements at the top of the list (feedback (FB) by SPs, rank 2; FB by trainer, rank 3; FB by colleagues, rank 4), whereas theoretical elements were at the bottom (theoretical introduction, rank 7; memory card, rank 9). Overall, student self-ratings of communication competence significantly improved in nine of the ten communication items assessed by VAS and showed a pre-post effect size of ES = 0.74 on a global rating. CONCLUSIONS: This study demonstrates that the training concept based on 360° behavioral feedback was well accepted and generated significant changes in student self-ratings of their communication competence. Further research is needed to determine the effects on objective communication performance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-016-0792-0) contains supplementary material, which is available to authorized users

Enhancing feedback literacy in the workplace: A learner-centred approach

This chapter discusses the development, implementation and evaluation of a learning intervention to enhance students’ workplace feedback literacy. Healthcare students want more feedback during placements. Students’ roles in feedback processes tend to be overlooked with most learning interventions focusing on professional development of educators, that is, how to ‘deliver’ feedback better (Carless et al., 2011). Addressing student’s role in feedback, as seeker, processer and user of performance information, offers an opportunity to improve placement and post-placement feedback experiences. The intervention aimed to augment students’ feedback literacy and their engagement during and after clinical placements at a teaching hospital. Informed by the learner-centred feedback model, Feedback Mark 2 (Boud D, Molloy E, Feedback in higher and professional education: understanding it and doing it well. Routledge, New York, 2013a, Boud D, Molloy E, Assess Eval High Educ, 38(6), 698–712. https://doi.org/10.1080/02602938.2012.691462, 2013b), the multifaceted intervention, which included an online primer, workshop and reflective activities, aimed to (1) support students’ self-evaluation of placement performance, (2) encourage students to seek and receive feedback from clinical supervisors and peers to compare internally and externally derived feedback and (3) use these comparisons to generate a plan for improved work. The intervention, performed 3 times with 105 students, was evaluated using 2 surveys and one-off interviews (n = 28). Students were highly satisfied with their intervention experiences and reported an enhanced understanding of the features of, and their role in, feedback processes. Moreover, students described being more actively engaged in placement feedback processes. They attributed these changes to feeling more empowered to ask for feedback to improve their performance. These findings suggest enhancing placement learning through student engagement in feedback needs to begin before placement, be enacted during placement and be consolidated following placement. This vertical reinforcement may occur through activities, which support feedback as a learning mechanism. Central to effective feedback engagement is planning for subsequent learning; thus, placement experiences and active feedback engagement will support students post-placement to plan and integrate further university-based learnings

Identifying Feedback That Has Impact

This chapter offers new insight regarding the theoretical, methodological and practical concerns relating to feedback in higher education. It begins with the construction of a new definition of feedback. We explain how feedback is a learner-centred process in which impact is a core feature. The chapter then explores the reasons why identifying, let alone measuring, impact is problematic. We briefly revisit the contingent nature of educational research into cause and effect and question the implications for feedback processes that are likely to be experienced by individuals in different ways with different effects over different timescales. It is here we then discuss some ways we conceive the various forms of feedback effect including the intentional and unintentional, immediate and delayed, cognitive, affective, motivational, relational and social