Time to Make Sense: Doctors' and Students' Experiences of Difficult Feedback.

IF 3.9 2区 医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Perspectives on Medical Education Pub Date : 2025-09-01 eCollection Date: 2025-01-01 DOI:10.5334/pme.1689
Leonie Griffiths, Joanne Hilder, Elizabeth Molloy, Anna Ryan, Christopher Watling
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引用次数: 0

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Discussion: 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.

时间有意义:医生和学生的困难反馈经验。
学习者对反馈对话的体验及其纵向影响,在很大程度上是教育工作者看不到的。虽然我们对有效的反馈对话有了更多的了解,但我们还没有完全理解学习者是如何随着时间的推移理解这些交流的。这对于理解练习反馈的效力,以及如何最好地支持学习者,特别是在经历具有挑战性的情况下,具有重要意义。本研究旨在探讨困难反馈的特征和反馈语义构建的时间方面。方法: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遇到困难反馈的书面叙述。开放式的提示有助于参与者描述他们的经历,随着时间的推移对它的评价,以及从中产生的学习。我们对数据进行了反思性的专题分析,并从建构主义的角度进行了分析。结果:困难反馈对话的特点是情绪、语义和学习之间不可预测的复杂互动。尽管一些反馈被认为是私人的、不恰当的或具有威胁性的,但反馈信息很少被忽视。参与者参与反馈分享和反思,这通常持续数年,有助于身份识别工作和临床实践的发展。讨论:我们的研究结果强调了困难反馈的语义理解的时间性质,并挑战了学习者在当下做出反应并致力于进步的期望。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,可以促进纵向意义构建过程。
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来源期刊
CiteScore
5.70
自引率
8.30%
发文量
31
审稿时长
28 weeks
期刊介绍: Perspectives on Medical Education mission is support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Official journal of the The Netherlands Association of Medical Education (NVMO). Perspectives on Medical Education is a non-profit Open Access journal with no charges for authors to submit or publish an article, and the full text of all articles is freely available immediately upon publication, thanks to the sponsorship of The Netherlands Association for Medical Education. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary. The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members. The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission. Perspectives on Medical Education positions itself at the dynamic intersection of educational research and clinical education. While other journals in the health professional education domain orient predominantly to education researchers or to clinical educators, Perspectives positions itself at the collaborative interface between these perspectives. This unique positioning reflects the journal’s mission to support and enrich collaborative scholarship between education researchers and clinical educators, and to advance new knowledge regarding clinical education practices. Reflecting this mission, the journal both welcomes original research papers arising from scholarly collaborations among clinicians, teachers and researchers and papers providing resources to develop the community’s ability to conduct such collaborative research. The journal’s audience includes researchers and practitioners: researchers who wish to explore challenging questions of health professions education and clinical teachers who wish to both advance their practice and envision for themselves a collaborative role in scholarly educational innovation. This audience of researchers, clinicians and educators is both international and interdisciplinary. The journal has a long history. In 1982, the journal was founded by the Dutch Association for Medical Education, as a Dutch language journal (Netherlands Journal of Medical Education). As a Dutch journal it fuelled educational research and innovation in the Netherlands. It is one of the factors for the Dutch success in medical education. In 2012, it widened its scope, transforming into an international English language journal. The journal swiftly became international in all aspects: the readers, authors, reviewers and editorial board members. The editorial board members represent the different parental disciplines in the field of medical education, e.g. clinicians, social scientists, biomedical scientists, statisticians and linguists. Several of them are leading scholars. Three of the editors are in the top ten of most cited authors in the medical education field. Two editors were awarded the Karolinska Institute Prize for Research. Presently, Erik Driessen leads the journal as Editor in Chief. Perspectives on Medical Education is highly visible thanks to its unrestricted online access policy. It is sponsored by theThe Netherlands Association of Medical Education and offers free manuscript submission.
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