"Had I been seen as an asset, I would have become one": key factors influencing how dietetics students engage with feedback processes in clinical placement.

Abstract

Workplace-based learning outcomes are results of a complex interplay between the opportunities and resources made available in the workplace, and the students' capacities to draw upon these. Students are expected to engage with the work environment and the feedback opportunities that occur. There is, however, limited understanding of the factors that promote and inhibit student engagement with feedback in ways that support learning during clinical placements, especially in dietetics where students meet few role models from their own profession. We employed an explorative interpretivist qualitative design using semi-structured individual interviews with bachelor students in dietetics (n = 11) at the University of Bergen, Norway, after their first clinical peer placement experience including a two-week preparatory course. Interviews were analysed using reflexive thematic analysis, informed by a conceptual framework for feedback literacy, within a relativist ontological positioning. Four themes which describe factors affecting student engagement with feedback were constructed: (1) Perceptions of task relevance, (2) Recognition of individual competence as feedback, (3) Alignment between external feedback and self-assessment, and (4) Preference for symmetrical relationships. The ambiguous scope of dietetic practice influences students' engagement with feedback and exacerbates challenges related to professional identity formation. For feedback engagement to be sparked, feedback processes must be characterised by tasks relevant for the profession, a sense of mattering, as well as mutual respect and dialogue between feedback provider and receiver. Our findings identified possible entry points for interventions to improve feedback practices in clinical placement.