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"Ask-Tell-Ask" approach encourages reflection and action
Reflection as a component of formative assessment appears to be instrumental in promoting the use of feedback; an observational study. Pelgrim, EAM et al. Medical Teacher 2013; 35(9): 772–778.
Reviewed by Dan Richards


What was the study question?
Does a learner's reflection-on-performance improve feedback and their use of feedback?

How was the study done?
In a general practice program in Nijmegen,the Netherlands, trainer-trainee pairs completed formative assessment forms following observed patient encounters. Trainees were given the opportunity to write narrative reflections and trainers were given the opportunity to write narrative feedback by answering the questions "what went well" and "what could have gone better" (Pendleton 1984). Pairs were also asked to develop an action plan together. The formative assessment tools were examined for specific reflection-on-performance, specific feedback, and specific action plans.

What were the results?
400 forms completed by 50 trainer-trainee pairs were analyzed. 66% of the forms contained specific (trainer) feedback and 34% of the forms contained specific (trainee) reflections. The forms contained an average of 0.53 specific comments related to an action plan, which is slightly more than one action plan per two forms. Trainer-trainee pairs that had "specific feedback AND specific reflections" had 1.02 specific comments related to an action plan per form, demonstrating a large effect on action plan.

What are the implications of these findings?
Reflective practice is an integral component of professional development and lifelong learning. This article supports the use of reflection-on-performance in formative assessment to enhance the learner's use of feedback in affecting action.

Editor's note: Perhaps the greatest thing these forms did was "force" trainees and teachers to connect with each other after a patient encounter and listen to each other perspectives of what was observed and learned (SLB).

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