Background In this research paper we report on the quality of feedback provided in the logbooks of pre-clinical undergraduate students based on a model of ‘actionable feedback’. Feedback to clinical learners about their performance is crucial to their learning, which ultimately impacts on their development into competent clinicians. Due to students’ concerns regarding the inconsistency and quality of feedback provided by clinicians, a structured feedback improvement strategy to move feedback forward was added to the clinical skills logbook. The instrument was also extended for peer assessment. This study aims to assess the quality of feedback using the deliberate practice framework. Methods A feedback scoring system was used to retrospectively assess the quality of tutor and peer logbook feedback provided to second and third year medical students to identify deliberate practice components i.e. task, performance gap and action plan. The sample consisted of 425 second year and 600 third year feedback responses over a year. Results All three deliberate practice components were observed in the majority of the written feedback for both classes. The frequency was higher in peer (83%, 89%) than tutor logbook assessments (51%, 67%) in both classes respectively. Average tutor and peer task, gap and action feedback scores ranged from 1.84–2.07 and 1.93–2.21 respectively. The overall quality of feedback provided by the tutor and peer was moderate and less specific (average score < or = 2). The absence of the three components was noted in only 1% of the feedback responses in both 2nd and 3rd year. Conclusion This study found that adding in a feed-forward strategy to the logbooks increased the overall quality of tutor and peer feedback as the task, gap and action plans were described. Deliberate practice framework provides an objective assessment of tutor and peer feedback quality and can be used for faculty development and training. The findings from our study suggest that the ratings from the tool can also be used as guidelines to provide feedback providers with feedback on the quality of feedback they provided. This includes specifically describing a task, performance gap and providing a learning plan as feed-forward to enhance feedback given. Electronic supplementary material The online version of this article (10.1186/s12909-019-1547-5) contains supplementary material, which is available to authorized users.

Background. Clinical skills training in the clinical skills laboratory (CSL) environment forms an important part of the undergraduate medical curriculum. These skills are better demonstrated than described. A lack of direct observation and feedback given to medical students performing these skills has been reported. Without feedback, errors are uncorrected, good performance is not reinforced and clinical competence is minimally achieved. Objectives. To explore the perceptions of 3rd-year medical students and their clinical teachers about formative clinical assessment feedback in the CSL setting. Methods.Questionnaires with open-and closed-ended questions were administered to 3rd-year medical students and their clinical skills teachers. Quantitative data were statistically analysed while qualitative data were thematically analysed. Results. Five clinical teachers and 183 medical students participated. Average scores for the items varied between 1.87 and 5.00 (1: negative to 5: positive). The majority of students reported that feedback informed them of their competence level and learning needs, and motivated them to improve their skills and participation in patient-centred learning activities. Teachers believed that they provided sufficient and balanced feedback. Some students were concerned about the lack of standardised and structured assessment criteria and variation in teacher feedback. No statistical difference (p<0.05) was found between the mean item ratings based on demographic and academic background. Conclusion. Most teachers and students were satisfied with the feedback given and received, respectively. Structured and balanced criterion-referenced feedback processes, together with feedback training workshops for staff and students, are recommended to enhance feedback practice quality in the CSL. Limited clinical staff in the CSL was noted as a concern.

Background: The Coronavirus Disease-2019 (COVID-19) pandemic in South Africa compelled medical schools to switch to a purely online curriculum. The innovative changes transformed the standard clinical skills curriculum to increase learning transfer to bridge the theory-practice gap. The efficacy of this intervention remains unknown. This study aims to measure medical students’ clinical competency in the affective, cognitive, and psychomotor domains by assessing clinical skills knowledge retention and transfer from the online platform compared to face-to-face and blended learning. Methods: A non-random cross-sectional quasi-experimental study assessed third-year medical students’ knowledge retention and learning transfer in three domains of clinical skills competence. Data were obtained using a score sheet during a directly observed formative and a trial online summative assessment. One hundred and one third-year medical students volunteered for the formative onsite assessment that tested the psychomotor domain. Two hundred and thirty-nine students were evaluated on the affective and cognitive domains in the summative online trial mini-objective structured clinical examination (tm-OSCE). The OSCE scores were analysed using descriptive statistics. The significance of the findings was evaluated by comparing OSCE scores with the pre-pandemic 2019 third-year medical students. Results: Statistically significant differences were found between the two cohorts of medical students from both years (p < 0.05). The 2021 blended group’s (n = 101) medians were 90%, 95%CI [86, 92], 82%, 95%CI [80, 85], and 87%, 95% CI [84, 90] for the psychomotor, affective, and cognitive skills, respectively. The e-learning group’s affective and cognitive skills medians were 78%, 95%CI [73, 79] and 76%, 95%CI [71, 78], respectively. The 2019 face-to-face cohort (n = 249) achieved medians of 70%, 95% CI [69, 72] and 84%, 95%CI [82, 86] for the affective and psychomotor skills, respectively. Conclusion: Medical students demonstrated near and far transfer bridging the theory-practice gap in three clinical skills domains. The blended group performed significantly better than the e-learning and face-to-face groups. Medical schools and educators play a vital role in overcoming learning challenges and achieving higher transfer levels by adopting multiple student-centered teaching delivery approaches and arranging immediate application opportunities. This study offers medical educators suggestions that encourage the transfer of online learning to face-to-face practice, decentralising medical education with a revised blended learning strategy.

not available Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 206-212

Objective: Many studies have explored feedback effectiveness using interventions focused on feedback delivery. It is equally important to consider how learners actively receive, engage with and interpret feedback. This study explores how medical students receive and use feedback in pre-clinical skills training. Method: Focus group data from 25 purposively selected thirdyear medical students was thematically analysed. Four major themes and eight sub-themes related to the facilitators and barriers to feedback receptivity and utilisation to feed forward emerged from the data. Results and Discussion: Students were receptive to feedback when its purpose and content aligned with their personal objectives, when it was consistent between tutors, and when it involved developing longitudinal relationships. The clinical skills formative logbook feedback culture with a learning focus was perceived to be predictive of their future performance and they were likely to take feedback on board, emphasising the role of reflection in this process. The depth and timing of actual feedback use varied among students, and language barriers hindered decoding feedback. Students’ self-regulatory focus on the feedback process had a dominant influence on their active use of feedback. Conclusion: Incorporating learner behaviour underlying feedback use should be considered when designing interventions to promote feedback engagement, feedback literacy skills and responsibility sharing in the feedback process. Establishing a learning culture that promotes shared responsibility between clinical educators and learners enable greater control by learners over assessment and feedback processes and a commitment to behaviour change. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.594-607