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What sports and music can teach us about feedback …                                
Learning Culture and Feedback: An International Study of Medical Athletes and Musicians  Watling C et al. Medical Education 2014;48:713-723.
Reviewed by Chris White

What was the study question?
How does the learning culture impact the quality of feedback in medical education?

How was the study done?
Twenty seven doctors or medical students who had been elite athletes (15) or musicians (12) prior to medical school underwent semi-structured interviews about feedback. This information underwent a qualitative analysis for key themes and relationships.

What were the results?
Three influences on the perception and value of feedback were found. The individual learner (motivation, attitude toward feedback) and feedback characteristics (specific, timely, actionable, credible) were stable in all three domains. However, the differences in learning culture between sports/music and medical education were profoundly different.

What are the implications of these findings?
The following issues in learning culture were identified. Expectations:  in sports or music, critical feedback is expected and valued, helping dampen its negative emotional impact. Critical feedback in medical education is perceived much more negatively. Teachers as evaluators in medical education:  this is a huge problem in the culture of feedback. The authors conclude, “Medicine should seriously consider decoupling coaching and assessment.” Goal alignment:  when teacher and learner goals are clearly aligned, positive and negative feedback is more productive and valued. Teacher-learner relationship:  meaningful feedback is more likely to be accepted in the context of a strong, trusting relationship between teacher and learner (longitudinal integrated clerkships really help here). Best quote from this article: “No matter how well intentioned or well crafted it is, feedback may be doomed to fail if it is not situated within a supportive learning culture.”

Editor’s note:  Here is another study demonstrating the benefits of creating a culture in medicine that resembles the culture in sports (or music) in which roles are clearly defined, feedback is expected and valued, and the preceptors as viewed, and act, as supportive coaches (SLB).

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