Supporting student and teacher feedback literacy: an instructional model for student feedback processes

Within the new feedback paradigm, the concept of student and teacher feedback literacy is gaining more and more attention, with most studies focussing on what it entails and how it can be supported by design. This paper contributes to this, by focussing on what students can do with feedback information. It proposes an instructional model for student feedback processes with the student activities seeking-, making sense of-, using- and responding to feedback information and specific prompts all four activities. Following Vygotsky, the model is built on the premise that effective feedback processes take place in social interaction with a more knowledgeable peer in the Zone of Proximal Development. In doing so, this is the first paper that addresses what students can do to contribute to scaffolded learning from feedback. The instructional model can be used by students to process feedback information and can be used by teachers to scaffold students’ feedback processes. So, it is intended to support both student and teacher feedback literacy and their interplay. Future studies need to empirically validate the effectiveness of this instructional model

‘A role model is like a mosaic’: reimagining URiM students’ role models in medical school

Background: Role modelling is a widely acknowledged element of medical education and it is associated with a range of beneficial outcomes for medical students, such as contributing to professional identity development and a sense of belonging. However, for students who are racially and ethnically underrepresented in medicine (URiM), identification with clinical role models may not be self-evident, as they have no shared ethnic background as a basis for social comparison. This study aims to learn more about the role models of URiM students during medical school and about the added value of representative role models. Methods: In this qualitative study we used a concept-guided approach to explore URiM alumni’s experiences with role models during medical school. We conducted semi-structured interviews with ten URiM alumni about their perception of role models, who their own role models were during medical school and why they considered these figures as role models. Sensitizing concepts guided the topic list, interview questions and finally served as deductive codes in the first round of coding. Results: The participants needed time to think about what a role model is and who their own role models are. Having role models was not self-evident as they had never thought about it before, and participants appeared hesitant and uncomfortable discussing representative role models. Eventually, all participants identified not one, but multiple people as their role model. These role models served different functions: role models from outside medical school, such as parents, motivated them to work hard. Clinical role models were fewer and functioned primarily as examples of professional behaviour. The participants experienced a lack of representation rather than a lack of role models. Conclusions: This study presents us with three ways to reimagine role models in medical education. First, as culturally embedded: having a role model is not as self-evident as it appears in existing role model literature, which is largely based on research conducted in the U.S. Second, as cognitive constructs: the participants engaged in selective imitation, where they did not have one archetypical clinical role model, but rather approach role models as a mosaic of elements from different people. Third, role models carry not only a behavioural but also a symbolical value, the latter of which is particularly important for URiM students because it relies heavier on social comparison

Supervisors’ untrained postgraduate rubric use for formative and summative purposes

Using rubrics can benefit the quality of assessment and learning. However, the conditions that stimulate or obstruct these benefits have been insufficiently studied. One underinvestigated claim is that rubrics are no substitution for good instruction and assessment and that teachers need training in utilising them. This is relevant since teachers in daily practice often use rubrics without training. In this study, we investigated data from a rubric filled out by supervisors who were not specifically trained in its use and used the rubric voluntarily. The rubric was designed for assessment moments with a formative and summative purpose. Results of quantitative analyses of 313 rubric forms indicated that the rubric was used flexibly: supervisors vary in using the rubric for the formative and/or summative purpose and in the criteria they assess. More criteria were omitted during formative use than during summative use. Some of these omitted criteria were most predictive for the final grade. This raises serious concerns with respect to the tension between flexible rubric use and constructive alignment. To understand the quality of rubric use in education, future research is needed on supervisors’ perceptions toward rubrics use. Supplemental data for this article is available online at https://doi.org/10.1080/02602938.2021.2021390

Supervisors’ untrained postgraduate rubric use for formative and summative purposes

Using rubrics can benefit the quality of assessment and learning. However, the conditions that stimulate or obstruct these benefits have been insufficiently studied. One underinvestigated claim is that rubrics are no substitution for good instruction and assessment and that teachers need training in utilising them. This is relevant since teachers in daily practice often use rubrics without training. In this study, we investigated data from a rubric filled out by supervisors who were not specifically trained in its use and used the rubric voluntarily. The rubric was designed for assessment moments with a formative and summative purpose. Results of quantitative analyses of 313 rubric forms indicated that the rubric was used flexibly: supervisors vary in using the rubric for the formative and/or summative purpose and in the criteria they assess. More criteria were omitted during formative use than during summative use. Some of these omitted criteria were most predictive for the final grade. This raises serious concerns with respect to the tension between flexible rubric use and constructive alignment. To understand the quality of rubric use in education, future research is needed on supervisors’ perceptions toward rubrics use. Supplemental data for this article is available online at https://doi.org/10.1080/02602938.2021.2021390

Preparing Medical and Nursing Students for Interprofessional Feedback Dialogues

Background: In healthcare education, preparing students for interprofessional feedback dialogues is vital. However, guidance regarding developing interprofessional feedback training programs is sparse. In response to this gap, the Westerveld framework, which offers principles for interprofessional feedback dialogue, was developed. Approach: Using the Westerveld framework, we developed and implemented an interprofessional feedback intervention for 4th-year nursing and 5th-year medical students. It encompasses two half-day workshops comprising small group sessions, interactive lectures, and a goal-setting assignment for the rotations. This paper describes the intervention and reflects on students’ self-reported goals, as learning outcomes, to inform future interprofessional feedback dialogue education. Outcomes:To understand student’s learning outcomes, we coded the content and specificity of 288 responses to the goal-setting assignment. Students indicated they mainly aimed to improve their feedback actionability, but contrastingly set – largely unspecific – goals, addressing the initiation of feedback dialogues. To better understand the process of setting these goals, we held three focus groups (N = 11): aside from the Westerveld framework, students used previous experience in rotations, outcome expectations, and personal characteristics as sources in their goal-setting process. Reflection: The contrast between students’ aims to improve their actionability and their goals to initiate dialogues, suggests that overcoming practice barriers to initiating dialogues are conditional to developing other feedback dialogue aspects. These and other goal conflicts in the workplace may hinder them setting specific feedback dialogue goals. We recommend explicit discussion of these challenges and conflicts in interprofessional feedback dialogue education.</p

Leadership practices in collaborative innovation: A study among Dutch school principals

School principals and teachers are expected to continuously innovate their practices in changing school environments. These innovation processes can be shared more widely through collaboration between principals and teachers, i.e. collaborative innovation. In order to gain more insight into how school principals enact their leadership practices in leading collaborative innovation, we interviewed 22 school principals of primary, secondary and vocational education in the Netherlands. All participants have implemented the same collaborative innovation programme, aimed at enhancement of collaboration between teachers and school principals within schools, that has already been implemented by 900 Dutch schools. They were interviewed twice during the implementation year. Interview transcripts were analysed using an open coding strategy looking for leadership practices. Based on 11 leadership practices, we described two main leadership patterns: school principals enacting leadership practices as either a team player or as a facilitator. We conclude that our findings suggest a wider repertoire of leadership practices than is reported in previous studies. Future studies would need to address the generalisability of the practices and patterns as found in this specific context of collaborative innovation

Describing and measuring leadership within school teams by applying a social network perspective

Despite the growing number of studies that acknowledge a crucial role of distributed leadership within schools, limited knowledge exists on how to describe and measure this multi-faceted concept. In a social network study with 130 respondents, from 14 Dutch school teams carrying out collaborative innovation, we theoretically describe three core aspects of the social interaction process of distributed leadership: collective, dynamic, or relational. Furthermore, we empirically explore how to measure all these three aspects of distributed leadership from a social network perspective, whereas most research focuses on either collective or dynamic. Our findings indicate that three network measures (density, reciprocity, indegree centralization) form a coherent combination to measure distributed leadership in school teams in terms of collective, relational, and dynamic, respectively. Furthermore, based on the combination of measures we found differences in distributed leadership between school teams. Thus, adding the relational aspect in addition to the collective and dynamic aspects seems to be informative to measure distributed leadership. Our study motivates to take a social network perspective, instead of the mostly used aggregation approaches, to measure distributed leadership in school teams

The Westerveld framework for interprofessional feedback dialogues in health professions education

Interprofessional feedback dialogues play a crucial role in educating the adaptive team members that health care practice requires. The aim of this study is to develop principles for interprofessional feedback dialogues, to support healthcare education on feedback processes in an interprofessional context. A critical review of the literature on (interprofessional) feedback, and discussions with local experts resulted in an initial framework. This was input for a two-round expert panel with international, leading scholars in the fields of feedback (n = 5) and interprofessional education (n = 5). Experts showed increased agreement and consensus over the rounds resulting in a framework, called the Westerveld framework, structured around seven criteria: Open and respectful; Relevant; Timely; Dialogical; Responsive; Sense making; and Actionable. The framework contains columns with feedback dialogue principles for information givers and users, and columns with additions to be taken into account in an interprofessional healthcare context. Structuring the information giver and user columns around the same criteria, emphasises shared responsibility of participants in a feedback dialogue. The integration of interprofessional additions facilitates transfer to the healthcare context. The Westerveld framework can provide guidance to teachers and students in interprofessional education, contributing to both student and teacher feedback literacy

The Westerveld framework for interprofessional feedback dialogues in health professions education

Interprofessional feedback dialogues play a crucial role in educating the adaptive team members that health care practice requires. The aim of this study is to develop principles for interprofessional feedback dialogues, to support healthcare education on feedback processes in an interprofessional context. A critical review of the literature on (interprofessional) feedback, and discussions with local experts resulted in an initial framework. This was input for a two-round expert panel with international, leading scholars in the fields of feedback (n = 5) and interprofessional education (n = 5). Experts showed increased agreement and consensus over the rounds resulting in a framework, called the Westerveld framework, structured around seven criteria: Open and respectful; Relevant; Timely; Dialogical; Responsive; Sense making; and Actionable. The framework contains columns with feedback dialogue principles for information givers and users, and columns with additions to be taken into account in an interprofessional healthcare context. Structuring the information giver and user columns around the same criteria, emphasises shared responsibility of participants in a feedback dialogue. The integration of interprofessional additions facilitates transfer to the healthcare context. The Westerveld framework can provide guidance to teachers and students in interprofessional education, contributing to both student and teacher feedback literacy

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