Empowering yourself to better participate in feedback: a new cognitive-behavioural model for medical learners

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DOI:

https://doi.org/10.36834/cmej.74419

Abstract

Sharing formative feedback is inherent in the supervision process and the acceptance of feedback by learners is an essential step in learning. However, receiving feedback from the supervisor evokes emotions and accepting it is not easy. Several recommendations guide preceptors on how to share feedback with learners and all emphasize the importance of encouraging the learner to actively interact in the feedback process. Although studies point to the positive effect of informing and training learners about feedback, few focus on their responsiveness to feedback. Under the rubric of developing a personal skill to better accept feedback, we propose a new behavioral model, called H.O.S.T., which aims to guide learners to approach feedback with a personal growth mindset associated with the learning position. Specifically, the model presents an interdependent set of attitudes and behaviors that aim to facilitate emotional management and engagement in the feedback process, in order to initiate the reflective process necessary for learning and to enable the acquisition of targeted skills. The acronym H.O.S.T. reminds students of the four essential elements of the behavioral model: humility, openness, shared explicitness and tenacity. Based on the positive psychology movement, each element is defined and justified by known theoretical concepts. In order to better assimilate the components of the model, the use of internal dialogue is adopted to facilitate the training and adoption of behaviors. The essence of the model is discussed in light of the feedback literacy dedicated to learners.

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References

Ende J. Feedback in clinical medical education. JAMA. 12 août 1983;250(6):777. https://doi.org/10.1001/jama.1983.03340060055026

Hattie J, Timperley H. The power of feedback. review of educational research. mars 2007;77(1):81‑112. https://doi.org/10.3102/003465430298487

Boud D, Molloy E, éditeurs. Feedback in higher and professional education: understanding it and doing it well. London ; New York: Routledge; 2013. 229 p. https://doi.org/10.4324/9780203074336

Archer JC. State of the science in health professional education: effective feedback: effective feedback in health professional education. Med ed. janv 2010;44(1):101‑8. https://doi.org/10.1111/j.1365-2923.2009.03546.x

Hattie J. Visible learning: a synthesis of over 800 meta-analyses relating to achievement. London ; New York: Routledge; 2009. 378 p.

Sargeant J, Mann K, Manos S, et al. R2C2 in action: testing an evidence-based model to facilitate feedback and coaching in residency. JGME. 1 avr 2017;9(2):165‑70. https://doi.org/10.4300/JGME-D-16-00398.1

Schwartzman L. On the nature of student defensiveness: theory and feedback from a software design course. In: Proceedings of the fifth international workshop on computing education research workshop - ICER ’09. Berkeley, CA, USA: ACM Press; 2009. p. 81. https://doi.org/10.1145/1584322.1584333

Schwartzman L. Student Defensiveness as a Threshold to Reflective Learning in Software Design. Inform Educ. 15 avr 2007;6(1):197‑214. https://doi.org/10.15388/infedu.2007.14

Pendleton David. The Consultation : an approach to learning and teaching [Internet]. Oxford [Oxfordshire]; New York: Oxford University Press; 1984. Disponible sur: http://books.google.com/books?id=njRrAAAAMAAJ

McGinness HT, Caldwell PHY, Gunasekera H, Scott KM. An educational intervention to increase student engagement in feedback. Med teach. 1 nov 2020;42(11):1289‑97. https://doi.org/10.1080/0142159X.2020.1804055

Algiraigri AH. Ten tips for receiving feedback effectively in clinical practice. Med Ed. janv 2014;19(1):25141. https://doi.org/10.3402/meo.v19.25141

Carless D, Boud D. The development of student feedback literacy: enabling uptake of feedback. Assess Eval High Educ. 17 nov 2018;43(8):1315‑25. https://doi.org/10.1080/02602938.2018.1463354

Eva KW, Armson H, Holmboe E, et al. Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes. Adv in Health Sci Educ. mars 2012;17(1):15‑26. https://doi.org/10.1007/s10459-011-9290-7

Bowen L, Marshall M, Murdoch-Eaton D. Medical student perceptions of feedback and feedback behaviors within the context of the “educational alliance”: Acad Med. sept 2017;92(9):1303‑12. https://doi.org/10.1097/ACM.0000000000001632

Carr SE, Siddiqui ZS, Jonas-Dwyer D, Miller S. Enhancing feedback for students across a health sciences faculty. 2013;8.

Ramani S, Könings KD, Ginsburg S, van der Vleuten CPM. Twelve tips to promote a feedback culture with a growth mind-set: Swinging the feedback pendulum from recipes to relationships. Med teach. 3 juin 2019;41(6):625‑31. https://doi.org/10.1080/0142159X.2018.1432850

Côté L, Breton E, Boucher D, Déry É, Roux J-F. L’alliance pédagogique en supervision clinique : une étude qualitative en sciences de la santé. Pédagogie Médicale. 1 nov 2017;18(4):161‑70. https://doi.org/10.1051/pmed/2018017

Davies K, Guckian J. How to ask for and act on feedback: practical tips for medical students. MedEdPublish [Internet]. 2018;7(1). https://doi.org/10.15694/mep.2018.0000063.1

Eva KW, Regehr G. Effective feedback for maintenance of competence: from data delivery to trusting dialogues. CMAJ. 2 avr 2013;185(6):463‑4. https://doi.org/10.1503/cmaj.121772

Giroux M, Girard G. Favoriser la position d’apprentissage grâce à l’interaction superviseur-supervisé. Pédagogie Médicale. août 2009;10(3):193‑210. https://doi.org/10.1051/pmed/20099991

Telio S, Ajjawi R, Regehr G. The “educational alliance” as a framework for reconceptualizing feedback in medical education: Acad Med. mai 2015;90(5):609‑14. https://doi.org/10.1097/ACM.0000000000000560

Telio S, Regehr G, Ajjawi R. Feedback and the educational alliance: examining credibility judgements and their consequences. Med Educ. sept 2016;50(9):933‑42. https://doi.org/10.1111/medu.13063

Dweck CS. Mindset: the new psychology of success. Ballantine Books trade pbk. ed. New York: Ballantine Books; 2008. 277 p.

Molloy E, Ajjawi R, Bearman M, Noble C, Rudland J, Ryan A. Challenging feedback myths: values, learner involvement and promoting effects beyond the immediate task. Med Educ. janv 2020;54(1):33‑9. https://doi.org/10.1111/medu.13802

Van De Ridder JMM, Stokking KM, McGaghie WC, Ten Cate OTJ. What is feedback in clinical education?: Feedback in clinical education. Med ed. 22 janv 2008;42(2):189‑97. https://doi.org/10.1111/j.1365-2923.2007.02973.x

Sargeant J, Mcnaughton E, Mercer S, Murphy D, Sullivan P, Bruce DA. Providing feedback: exploring a model (emotion, content, outcomes) for facilitating multisource feedback. Med teach. sept 2011;33(9):744‑9. https://doi.org/10.3109/0142159X.2011.577287

Boud D, Molloy E. Rethinking models of feedback for learning: the challenge of design. Assess Eval High Educ. sept 2013;38(6):698‑712. https://doi.org/10.1080/02602938.2012.691462

Bing-You RG, Bertsch T, Thompson JA. coaching medical students in receiving effective feedback. Teach learn med.oct 1998;10(4):228‑31. https://doi.org/10.1207/S15328015TLM1004_6

Winstone NE, Nash RA, Parker M, Rowntree J. Supporting learners’ agentic engagement with feedback: a systematic review and a taxonomy of recipience processes. Educ Psychologist. 2 janv 2017;52(1):17‑37. https://doi.org/10.1080/00461520.2016.1207538

Noble C, Billett S, Armit L, et al. “It’s yours to take”: generating learner feedback literacy in the workplace. Adv in Health Sci Educ. mars 2020;25(1):55‑74. https://doi.org/10.1007/s10459-019-09905-5

Molloy E, Boud D, Henderson M. Developing a learning-centred framework for feedback literacy. Assess Eval High Educ. 18 mai 2020;45(4):527‑40. https://doi.org/10.1080/02602938.2019.1667955

Dewey J. How we think: a restatement of the relation of reflective thinking to the educative process. Boston: Houghton Mifflin; 1998. 301 p.

Segal S. The existential conditions of eplicitness: an Heideggerian perspective. Studies in Continuing Education. mai 1999;21(1):73‑89. https://doi.org/10.1080/0158037990210105

Ramani S, Könings K, Mann KV, van der Vleuten C. Uncovering the unknown: A grounded theory study exploring the impact of self-awareness on the culture of feedback in residency education. Medical Teacher [Internet]. 3 oct 2017;39(10):1065‑73. Disponible sur: https://www.tandfonline.com/doi/full/10.1080/0142159X.2017.1353071 [cité 15 juin 2022]

Schön DA. The Reflective Practitioner [Internet]. 0 éd. Routledge; 2017 [cité 1 juin 2022]. Disponible sur: https://www.taylorfrancis.com/books/9781351883160

Duval S, Wicklund RA. A theory of objective self awareness. New York: Academic Press; 1972. 238 p. (Social psychology).

Watkins CE, Hook JN, Mosher DK, Callahan JL. Humility in clinical supervision: Fundamental, foundational, and transformational. The Clinical Supervisor. 2 janv 2019;38(1):58‑78. https://doi.org/10.1080/07325223.2018.1487355

Lee S, Wang T, Ren X. Inner speech in the learning context and the prediction of students’ learning strategy and academic performance. Educ Psych. 27 mai 2020;40(5):535‑49. https://doi.org/10.1080/01443410.2019.1612035

Edward Watkins C, Hook JN, Ramaeker J, Ramos MJ. Repairing the ruptured supervisory alliance: humility as a foundational virtue in clinical supervision. The Clinical Supervisor. 2 janv 2016;35(1):22‑41. https://doi.org/10.1080/07325223.2015.1127190

Van Tongeren DR, Davis DE, Hook JN, Witvliet C vanOyen. Humility. Curr Dir Psychol Sci. oct 2019;28(5):463‑8. https://doi.org/10.1177/0963721419850153

Haggard M, Rowatt WC, Leman JC, et al. Finding middle ground between intellectual arrogance and intellectual servility: Development and assessment of the limitations-owning intellectual humility scale. Personality and Individual Differences. avr 2018;124:184‑93. https://doi.org/10.1016/j.paid.2017.12.014

Davis DE, Rice K, McElroy S, et al. Distinguishing intellectual humility and general humility. J Positive Psych. 3 mai 2016;11(3):215‑24. https://doi.org/10.1080/17439760.2015.1048818

Dewey J. How we think: a restatement of the relation of reflective thinking to the educative process. Boston: Houghton Mifflin; 1998. 301 p.

Hare W. Education for an unsettled world: Dewey’s conception of open-mindedness. J Thought. vol. 39, No3. Fall 2004;111‑27.

Dweck CS, Walton GM, Cohen GL. ED576649.pdf [Internet]. Disponible sur: https://files.eric.ed.gov/fulltext/ED576649.pdf [cité 8 oct 2021].

Famington CA. Teaching adolescents to become learners: the role of noncognitive factors in shaping school performance : a critical literature review [Internet]. Chicago: University of Chicago, Consortium on Chicago School Research; 2012 Disponible sur: http://bibpurl.oclc.org/web/49257 http://ccsr.uchicago.edu/sites/default/files/publications/Noncognitive%20Report.pdf [cité 3 août 2021].

ED576649.pdf [Internet]. Disponible sur: https://files.eric.ed.gov/fulltext/ED576649.pdf [cité 8 oct 2021].

Crommelinck M, Anseel F. Understanding and encouraging feedback-seeking behaviour: a literature review: Feedback-seeking behaviour: a review. Med ed. mars 2013;47(3):232‑41. https://doi.org/10.1111/medu.12075

Sedikides C, Strube MJ. Self-evaluation: to thine own self be good, to thine own self be sure, to thine own self be true, and to thine own self be better. Advances Exper Social Psych [Internet]. Elsevier; 1997 p. 209‑69. https://doi.org/10.1016/S0065-2601(08)60018-0

Vermersch P. Entretien d’explicitation. In: Vocabulaire des histoires de vie et de la recherche biographique [Internet]. Toulouse: Érès; 2019. p. 340‑2. (Questions de société). https://doi.org/10.3917/eres.delor.2019.01.0340

Noble C, Sly C, Collier L, Armit L, Hilder J, Molloy E. Enhancing Feedback Literacy in the Workplace: A Learner-Centred Approach. In: Billett S, Newton J, Rogers G, Noble C, éditeurs. Augmenting health and social care students’ clinical learning experiences: outcomes and processes [Internet]. Cham: Springer International Publishing; 2019. p. 283‑306. https://doi.org/10.1007/978-3-030-05560-8_13

Ajjawi R, Molloy E, Bearman M, Rees CE. Contextual Influences on Feedback Practices: An Ecological Perspective. In: Carless D, Bridges SM, Chan CKY, Glofcheski R, éditeurs. Scaling up Assessment for Learning in Higher Education [Internet]. Singapore: Springer Singapore; 2017 p. 129‑43. (The Enabling Power of Assessment; vol. 5). https://doi.org/10.1007/978-981-10-3045-1_9

Published

2022-10-31

How to Cite

1.
Bouchard-Lamothe D, Rowe J, Boet S, Denis-LeBlanc M. Empowering yourself to better participate in feedback: a new cognitive-behavioural model for medical learners . Can. Med. Ed. J [Internet]. 2022 Oct. 31 [cited 2024 Jul. 20];14(3):6-13. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/74419

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