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Boehler M, Rogers DA, Schwind
CJ et al., An investigation of medical student reactions to feedback:
a randomized controlled trial. Medical Education, August 2006; 40(8):pp.
746-749. What is the problem and what is known about it so far?
As
pediatric clerkship directors, we all have "hawks" and the "doves"
among our faculty and we spend much of our time trying to convince both of the
value of feedback to students. We all recognize the value of feedback, but most
of us struggle with the question: What is the best format for that feedback?
Why did the researchers do this particular study?
In this simple but well-designed
study, the authors measured the differences in student performance and satisfaction
in two randomized groups: one group received specific feedback directed at deficiencies
while the other experienced non-specific praise. Who was studied?
Thirty-three
M1 and M2 students participated. How was the study done?
The study
focused on a simple motor task: the two-handed surgical square knot. All student
attempts were videotaped. Study participants were first videotaped tying a knot
with no prior instruction (the pre-test). An academic surgeon then demonstrated
how to correctly tie the knot. Students were then taped a second time (post-instruction,
pre-intervention). Half the students were then assigned to the generic compliments
group. During their third knot-tying exercise, these students heard scripted praise
such as "great job" or "outstanding." The other students were
assigned to the performance-based feedback group. These students were given 2
specific instructions addressing their deficiencies while tying the third knot.
Students were then taped tying a 4th knot. At the conclusion of the
session, students were asked to rate their satisfaction with the experience. All
videos were reviewed in random order by 3 blinded reviewers who rated performance
using a validated instrument. What did the researchers find?
The
feedback group performed better but students were was less satisfied with the
experience. The generic compliment group did not improve their performance but
were more satisfied with the experience. What were the limitations of
the study?
The study looked at a simple motor task and included a very small
number of only M2 and M3 students at a single medical school. Feedback sessions
were very brief; this might have contributed to student dissatisfaction with the
feedback. What were the implications of the study?
Individualized feedback
improves performance. When evaluating education systems or programs, performance
improvement is a better measure of the effectiveness of feedback than learner
satisfaction. Praise does not improve performance, but it does lead to more satisfied
learners. This study lends credibility to the "sandwich" technique of
giving feedback: praise / constructive criticism / praise. (Editorial
comment: This is a fascinating small study that confirms what many have felt for
a long time; students crave specific formative feedback but also don't like bad
news. Educators have to take solace in fact that while the faculty or teaching
session student evaluation could take a hit, specific feedback will improve student
performance-which is the ultimate goal. Bill Raszka) | 
