Subha Ramani1, Karen D Könings, Shiphra Ginsburg, Cees P M van der Vleuten. 1. S. Ramani is associate professor of medicine, Harvard Medical School, director, Scholars in Medical Education Pathway, Internal Medicine Residency Program, Brigham and Women's Hospital, and leader of research and scholarship, Harvard Macy Institute, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-8360-4031. K.D. Könings is associate professor, Department of Educational Development and Research and School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0003-0063-8218. S. Ginsburg is professor of medicine (respirology) and scientist, Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada. C.P.M. van der Vleuten is director, School of Health Professions Education, and professor of education, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0001-6802-3119.
Abstract
PURPOSE: Newer definitions of feedback emphasize learner engagement throughout the conversation, yet teacher and learner perceptions of each other's behaviors during feedback exchanges have been less well studied. This study explored perceptions of residents and faculty regarding effective behaviors and strategies during feedback conversations and factors that affected provision and acceptance of constructive feedback. METHOD: Six outpatient internal medicine preceptors and 12 residents at Brigham and Women's Hospital participated (2 dyads per preceptor) between September 2017 and May 2018. Their scheduled feedback conversations were observed by the lead investigator, and one-on-one interviews were conducted with each member of the dyad to explore their perceptions of the conversation. Interviews were transcribed and analyzed for key themes. Because participants repeatedly emphasized teacher-learner relationships as key to meaningful feedback, a framework method of analysis was performed using the 3-step relationship-centered communication model REDE (relationship establishment, development, and engagement). RESULTS: After participant narratives were mapped onto the REDE model, key themes were identified and categorized under the major steps of the model. First, establishment: revisit and renew established relationships, preparation allows deeper reflection on goals, set a collaborative agenda. Second, development: provide a safe space to invite self-reflection, make it about a skill or action. Third, engagement: enhance self-efficacy at the close, establish action plans for growth. CONCLUSIONS: Feedback conversations between longitudinal teacher-learner dyads could be mapped onto a relationship-centered communication framework. Our study suggests that behaviors that enable trusting and supportive teacher-learner relationships can form the foundation of meaningful feedback.
PURPOSE: Newer definitions of feedback emphasize learner engagement throughout the conversation, yet teacher and learner perceptions of each other's behaviors during feedback exchanges have been less well studied. This study explored perceptions of residents and faculty regarding effective behaviors and strategies during feedback conversations and factors that affected provision and acceptance of constructive feedback. METHOD: Six outpatient internal medicine preceptors and 12 residents at Brigham and Women's Hospital participated (2 dyads per preceptor) between September 2017 and May 2018. Their scheduled feedback conversations were observed by the lead investigator, and one-on-one interviews were conducted with each member of the dyad to explore their perceptions of the conversation. Interviews were transcribed and analyzed for key themes. Because participants repeatedly emphasized teacher-learner relationships as key to meaningful feedback, a framework method of analysis was performed using the 3-step relationship-centered communication model REDE (relationship establishment, development, and engagement). RESULTS: After participant narratives were mapped onto the REDE model, key themes were identified and categorized under the major steps of the model. First, establishment: revisit and renew established relationships, preparation allows deeper reflection on goals, set a collaborative agenda. Second, development: provide a safe space to invite self-reflection, make it about a skill or action. Third, engagement: enhance self-efficacy at the close, establish action plans for growth. CONCLUSIONS: Feedback conversations between longitudinal teacher-learner dyads could be mapped onto a relationship-centered communication framework. Our study suggests that behaviors that enable trusting and supportive teacher-learner relationships can form the foundation of meaningful feedback.
Authors: Jocelyn Lockyer; Heather Armson; Karen D Könings; Rachelle C W Lee-Krueger; Amanda Roze des Ordons; Subha Ramani; Jessica Trier; Mary Grace Zetkulic; Joan Sargeant Journal: J Grad Med Educ Date: 2020-02