Margaret C. Emmott,University of California, San Francisco,San Francisco,CA,Jennifer B. Soep,University of Colorado, School of Medicine,Aurora,CO,Tai M. Lockspeiser,University of Colorado, School of Medicine,Aurora,CO,Janice L. Hanson,University of Colorado, School of Medicine,Aurora,CO
Background: Feedback and evaluative comments are commonly employed to promote clinical improvement and inform grades. Unfortunately, current feedback and evaluation systems fall short for many learners. Neither the student perspective nor the environmental factors shaping students’ experience and progress are fully understood or represented in the literature.
Objectives: To study third-year medical students’ experiences with feedback and evaluation and identify contextual factors that shape these experiences.
Methods: Semi-structured interviews with third-year students were conducted by trained fourth-year peers. Interviews elicited students’ descriptions of experience with feedback and evaluation. A phenomenological framework was employed for data collection and analysis. All interviews were audio-recorded, transcribed, and independently coded by at least two investigators. All investigators identified codes, coded interviews and discussed themes. Disagreements were resolved by consensus.
Results: Twenty-four students participated. Five themes were identified characterizing the students’ experience with feedback and evaluation and highlighting different factors influencing their experience. 1. Impact of feedback – how students defined feedback (comments about their work that helped them learn and progress) and the qualities of feedback that affected its educational meaningfulness. 2. Impact of evaluation and grades – a stressful process for students that isoften discordant with their learning or progress, not reflective of their perceived performance, and based on obscure processes and content. 3. Educational environment – variable culture in different clinical settings, limited scope of clinical skills observed, and student perception that receiving feedback and evaluation was burdensome. 4. Human context/relationships – educator/learner dedication to student improvement, variable length of educational relationship, and limited skill in providing/receiving comments. 5. Forms – how students used available forms, educators and learners varying levels of comfort with forms, and the utility of each component of the forms.
Discussion: This study provides insight into the student experience with formative comments, evaluation, and grading. The findings suggest the importance of careful consideration of the use of different forms to gather comments, utilizing a grading process that is transparent, and creating professional development programs emphasizing relationship-building strategies for both learners and educators.