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Formative assessments: Trainees and supervisors take on what works and what doesn't
A qualitative study on trainees' and supervisors' perceptions of assessment for learning in postgraduate medical education. Dijksterhuis MGK et al. Medical Teacher 2013; 35:e1396-e1402.
Reviewed by Gary Beck

What was the study question?
What factors determine active engagement in formative feedback from the perspectives of trainees and supervisors?

How was the study done?
Focus groups were conducted with OB/GYN trainees and supervisors in the Netherlands. Three groups of supervisors (5-9 participants/group) and four groups of trainees (5-8 participants/group), discussed nine questions to elucidate the current assessment structure and expectations and needs regarding assessment. Group recordings were transcribed, coded, and analyzed.

What were the results?
Three themes emerged: individual perspectives of feedback determined by ownership and achievement orientation; supportiveness of the learning environment, defined as having clear standards and consequences for performance, committed supervisors, and acknowledgement by hospital administration of the importance of teaching; and credibility of the feedback and/or feedback giver. Trainees commented feedback was better received from supervisors who were perceived as role models, were well-respected, and encouraging.

What are the implications of these findings?
Expectations that junior trainees will actively solicit feedback may be misplaced. Trainees in the first stages of training are usually more focused on learning how to cope with the new working environment, i.e., "survival." The development of feelings of ownership develop with experience and coincide with an increased interest in seeking feedback. Learners look to supervisors to be role models, which affects how learners respond to feedback.

Editor's note: As stated by the authors, "progress in training years and progressive independence increase the awareness of personal responsibility for and an active approach of trainees to their learning pathway." How to nurture this transition is the challenge to clinical teachers (RR).

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