Receiving Real-Time Clinical Feedback: A Workshop and OSTE Assessment for Medical Students

Andrew Matthews; Matthew Hall; Jose M Parra; Margaret M Hayes; Christine P Beltran; Brittany L Ranchoff; Amy M Sullivan; Jeffrey H William

doi:10.2147/AMEP.S271623

Receiving Real-Time Clinical Feedback: A Workshop and OSTE Assessment for Medical Students

Adv Med Educ Pract. 2020 Nov 12:11:861-867. doi: 10.2147/AMEP.S271623. eCollection 2020.

Authors

Andrew Matthews¹, Matthew Hall², Jose M Parra³, Margaret M Hayes⁴, Christine P Beltran³, Brittany L Ranchoff⁵, Amy M Sullivan⁴, Jeffrey H William²

Affiliations

¹ Perelman School of Medicine, University of Pennsylvania Health Systems, Department of Medicine, Philadelphia, PA, USA.
² Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
³ Carl J. Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁴ Harvard Medical School; Carl J. Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁵ Department of Health Promotion and Policy, University of Massachusetts Amherst School of Public Health and Health Sciences, Amherst, MA, USA.

Abstract

Background: Many programs designed to improve feedback to students focus on faculty's ability to provide a safe learning environment, and specific, actionable suggestions for improvement. Little attention has been paid to improving students' attitudes and skills in accepting and responding to feedback effectively. Effective "real-time" feedback in the clinical setting is dependent on both the skill of the teacher and the learner's ability to receive the feedback. Medical students entering their clinical clerkships are not formally trained in receiving feedback, despite the significant amount of feedback received during this time.

Methods: We developed and implemented a one-hour workshop to teach medical students strategies for effectively receiving and responding to "real-time" (formative) feedback in the clinical environment. Subjective confidence and skill in receiving real-time feedback were assessed in pre- and post-workshop surveys. Objective performance of receiving feedback was evaluated before and after the workshop using a simulated feedback encounter designed to re-create common clinical and cognitive pitfalls for medical students, called an objective structured teaching exercise (OSTE).

Results: After a single workshop, students self-reported increased confidence (mean 6.0 to 7.4 out of 10, P<0.01) and skill (mean 6.0 to 7.0 out of 10, P=0.10). Compared to pre-workshop OSTE scores, post-workshop OSTE scores objectively measuring skill in receiving feedback were also significantly higher (mean 28.8 to 34.5 out of 40, P=0.0131).

Conclusion: A one-hour workshop dedicated to strategies in receiving real-time feedback may improve effective feedback reception as well as self-perceived skill and confidence in receiving feedback. Providing strategies to trainees to improve their ability to effectively receive feedback may be a high-yield approach to both strengthen the power of feedback in the clinical environment and enrich the clinical experience of the medical student.

Keywords: OSTE; feedback; learning environment; medical student.