How does a move towards a coaching approach impact the delivery of written feedback in undergraduate clinical education?

Abstract

Feedback uptake relies on interactions between learners and educators Winstone (Educ Psychol 52: 17–37, 2017). Feedback that coaches using a feedforward approach, is considered to be more personal and emotionally literate Bussey (Bull R Coll Surg Engl 99: 180–182, 2017), Hattie (Rev Educ Res 77: 81–112, 2007). Many modes of feedback are employed in clinical teaching environments, however, written feedback is particularly important, as a component of feedback discourse, as significant time may elapse before a similar clinical situation is encountered. In practice, time constraints often result in brief or descriptive written feedback rather than longer coaching feedback. This study aimed to explore whether a change in ethos and staff development would encourage clinical dental tutors to utilise a coaching approach in their written feedback. Across two time-points, written feedback was categorised into either descriptive, evaluative or coaching approaches. Cross-sections of data from 2017 to 2019 were examined to determine whether changes in practice were noted and whether there were any alterations in the affective nature of the language used. Feedback moved significantly towards coaching and away from a descriptive approach. A shift towards the use of more positive language was seen overall, although this was solely driven by a change in the evaluative feedback category. Descriptive feedback generally used neutral language with coaching feedback using marginally more positive language. Both categories employed significantly lower levels of affective language than evaluative feedback. These data indicate a move towards feedback approaches and language that may support increased uptake and utilisation of feedback.

Use the right words: evaluating the effect of word choice and word count on quality of narrative feedback in ophthalmology competency-based medical education assessments

“…Roberts et al found that written feedback could be both succinct (on average less than 20 words per comment) and categorized as coaching feedback with recommendations for next steps. 19 As the culture of assessment shifts and CBME becomes engrained in PGME across Canada, we have the opportunity to direct focus on optimizing narrative feedback to train not just competent, but excellent physicians.…”

“…3 Feedback that uses coaching language instead of generalized descriptions of the learning interaction is more effective, and signals recommendations for resident improvement. 19 One of the commonly cited barriers to faculty participation in CBME is time; there is an ever-expanding amount of clinical, teaching, and academic duties for a teaching physician. 16,20 With competing interests and depleting resources, making feedback delivery efficient by using words/phrases with the most impact ensures that coaching quality does not suffer under these constraints.…”