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      Twelve tips to promote a feedback culture with a growth mind-set: Swinging the feedback pendulum from recipes to relationships

      Author(s): 1 , 2 , 3 , 4 , 2
      Publication date Created:
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      Journal: Medical Teacher
      Publisher: Informa UK Limited

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          Abstract

          Feedback in medical education has traditionally showcased techniques and skills of giving feedback, and models used in staff development have focused on feedback providers (teachers) not receivers (learners). More recent definitions have questioned this approach, arguing that the impact of feedback lies in learner acceptance and assimilation of feedback with improvement in practice and professional growth. Over the last decade, research findings have emphasized that feedback conversations are complex interpersonal interactions influenced by a multitude of sociocultural factors. However, feedback culture is a concept that is challenging to define, thus strategies to enhance culture are difficult to pin down. In this twelve tips paper, we have attempted to define elements that constitute a feedback culture from four different perspectives and describe distinct strategies that can be used to foster a learning culture with a growth mind-set.

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          Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes

          Kevin Eva, Heather Armson, Eric F. Holmboe … (2011)
          Self-appraisal has repeatedly been shown to be inadequate as a mechanism for performance improvement. This has placed greater emphasis on understanding the processes through which self-perception and external feedback interact to influence professional development. As feedback is inevitably interpreted through the lens of one’s self-perceptions it is important to understand how learners interpret, accept, and use feedback (or not) and the factors that influence those interpretations. 134 participants from 8 health professional training/continuing competence programs were recruited to participate in focus groups. Analyses were designed to (a) elicit understandings of the processes used by learners and physicians to interpret, accept and use (or not) data to inform their perceptions of their clinical performance, and (b) further understand the factors (internal and external) believed to influence interpretation of feedback. Multiple influences appear to impact upon the interpretation and uptake of feedback. These include confidence, experience, and fear of not appearing knowledgeable. Importantly, however, each could have a paradoxical effect of both increasing and decreasing receptivity. Less prevalent but nonetheless important themes suggested mechanisms through which cognitive reasoning processes might impede growth from formative feedback. Many studies have examined the effectiveness of feedback through variable interventions focused on feedback delivery. This study suggests that it is equally important to consider feedback from the perspective of how it is received. The interplay observed between fear, confidence, and reasoning processes reinforces the notion that there is no simple recipe for the delivery of effective feedback. These factors should be taken into account when trying to understand (a) why self-appraisal can be flawed, (b) why appropriate external feedback is vital (yet can be ineffective), and (c) why we may need to disentangle the goals of performance improvement from the goals of improving self-assessment.
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            Facilitated Reflective Performance Feedback: Developing an Evidence- and Theory-Based Model That Builds Relationship, Explores Reactions and Content, and Coaches for Performance Change (R2C2).

            Joan Sargeant, Jocelyn Lockyer, Karen Mann … (2015)
            To develop and conduct feasibility testing of an evidence-based and theory-informed model for facilitating performance feedback for physicians so as to enhance their acceptance and use of the feedback.
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              A test of the influence of goal orientation on the feedback-seeking process.

              Jeffrey L Cummings, D VandeWalle (1997)
              A longitudinal field study (N = 44) and a scenario study (N = 239) were conducted to investigate the influence of the individual difference of goal orientation (an orientation toward developing or demonstrating one's ability) on feedback-seeking behavior by the inquiry method. The results of the 2 studies were consistent with the hypotheses of a positive relationship between a learning-goal orientation and feedback seeking and of a negative relationship between a performance-goal orientation and feedback seeking. Also as hypothesized, the perceived cost and perceived value of feedback seeking mediated these relationships. The theoretical and practical implications of the research are discussed.
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                Author and article information

                Journal
                Title: Medical Teacher
                Abbreviated Title: Medical Teacher
                Publisher: Informa UK Limited
                ISSN (Print): 0142-159X
                ISSN (Electronic): 1466-187X
                Publication date Created: April 22 2018
                Publication date Created: June 03 2019
                Publication date (Electronic): February 07 2018
                Publication date (Print): June 03 2019
                Volume: 41
                Issue: 6
                Pages: 625-631
                Affiliations
                [1 ] Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;
                [2 ] Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands;
                [3 ] Department of Medicine, University of Toronto, Toronto, Canada;
                [4 ] Wilson Centre for Research in Education, Faculty of Medicine, University of Toronto, Toronto, Canada
                Article
                DOI: 10.1080/0142159X.2018.1432850
                PubMed ID: 29411668
                SO-VID: 27801a93-b4e4-494e-9143-bb699243c04f
                Copyright © © 2019
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