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<ul><li><p>4 REd Teaching Resource for Rural Clinical Educators, Issue 17 March 2012 </p><p>Review </p><p>Giving Students Effective Written </p><p>Feedback </p><p>By Deirdre Burke and Jackie Pieterick </p><p>McGraw Hill Open University Press 2010 </p><p>Although this book focuses on feedback </p><p>for student written compositions, its </p><p>message is clear for any supervisors </p><p>giving feedback to students. It discusses </p><p>what feedback is, how it can be utilized as </p><p>a teaching tool and offers a number of </p><p>practical activities for students and tutors </p><p>to analyse written feedback to see if it is </p><p>understood and can be actioned. One </p><p>chapter includes case studies involving </p><p>students from Science, History, Education </p><p>and academic skills courses involving </p><p>different methods of feedback online </p><p>and on paper. The annotated bibliography </p><p>could be useful for tutors who would like to </p><p>explore aspects of feedback in more depth </p><p>including how feedback advances student </p><p>learning. </p><p>Find out more For more information on how to apply </p><p>feedback in learning and teaching, go to </p><p>these university websites: </p><p>Centre for the Advancement of </p><p>Teaching and learning - University of </p><p>Western Australia </p><p>http://www.catl.uwa.edu.au/resources/</p><p>assessment </p><p>Scroll down the page to the links about </p><p>giving effective formative feedback and </p><p>grading class participation. . </p><p>Higher Education academy </p><p>http://www.heacademy.ac.uk/resources/</p><p>detail/assessment/feedback-resources </p><p>Provides links to how students view </p><p>effective feedback, feeding forward and </p><p>engaging students with feedback. Links </p><p>include a seminar series on assessment </p><p>and feedback. </p><p>What the literature says </p><p>Emmerson, S., Tillard, G., Ormond, T., </p><p>Ramsay, R. &amp; Moore, B. (2011) Questions </p><p>posed within written feedback in clinical </p><p>education: a research note. The Open </p><p>Rehabilitation Journal 4, 28-31 </p><p>An analysis of written feedback given to </p><p>novice and more advanced Speech </p><p>Pathology students. The advanced </p><p>students were given more high level </p><p>questions (according to Blooms </p><p>Taxonomy) to promote critical thinking </p><p>than the novice students. This promoted </p><p>discussion about the importance of </p><p>facilitating critical thinking for all levels of </p><p>students. </p><p>Parker, P. M .&amp; Baughan, P. (2011). </p><p>Providing written feedback that students </p><p>will value and read. The international </p><p>journal of learning. 16(11), 253 - 262. </p><p>Teachers undertook a self-assessment, </p><p>writing feedback about their own essays </p><p>that was then analysed against criteria </p><p>from the literature review about effective </p><p>feedback. Despite 82% providing specific </p><p>feedback that met the criteria, only 4% </p><p>gave feedback that suggested areas for </p><p>development and review for all criteria. </p><p>Ferguson, P. (2011): Student perceptions </p><p>of quality feedback in teacher education. </p><p>Assessment &amp; Evaluation in Higher </p><p>Education. 36:1, 51-62 </p><p>A study of undergraduate and graduate entry education students perceptions of the effectiveness of written feedback. Students reported that written feedback that was timely and personalized regarding their specific piece of work was the best feedback option. This feedback needed to be positive, clear and constructive with a focus on acknowledging their successes and guiding them towards future improvement. </p><p> Giving learners feedback is just about the most important dimension of the work of teachers in post-compulsory education. Phil Race, educationalist </p><p>About REd </p><p>REd is published four times a year by the North West </p><p>Rural Medical Education Unit of the Monash </p><p>University School of Rural Health. It provides </p><p>resources and practical tools for clinical educators. </p><p>Back issues are available. Phone (03) 5440 9000 or </p><p>see our web site: www.med.monash.edu.au/med/srh/</p><p>medical-education/resources.html </p><p>If you would like each issue of REd sent directly to </p><p>you, contact pam.harvey@monash.edu </p><p>ISSN: 1835-1891 </p><p>Contents </p><p>1. Written Feedback in Health Professional Education </p><p>2. In FocusForward-looking Feedback </p><p>3. In PracticeUsing FIT in clinical supervision </p><p>4. Review: Giving Students Effective Written Feedback What the literature says </p><p> Find out more </p><p>Written Feedback in Health Professional Education </p><p>Published by the North West Rural Medical Education Unit, Issue 17 March 2012 </p><p>Formative Feedback </p><p> Feedback to learners about their </p><p>performance during a range of tasks is an </p><p>essential part of an effective learning and </p><p>teaching process. In clinical education, </p><p>feedback is provided in a number of ways, </p><p>including a grade on a test, during the </p><p>performance of a clinical skill or in </p><p>reflection after a learner has completed a </p><p>particular task. The common agreement </p><p>about feedback is that it should be specific </p><p>to the performance, timely and provide </p><p>enough (but not too much) information for </p><p>the student to use. What, then, is the role </p><p>of written feedback in clinical education? </p><p>This issue of REd investigates why written </p><p>feedback also needs to meet the criteria </p><p>for an effective learning tool, and presents </p><p>a practical model on how this can be done </p><p>in clinical education. It discusses its </p><p>usefulness as a reference point for </p><p>students to plan their future learning. </p><p>Pam Harvey and Natalie Radomski </p><p>North West Rural Medical Education Unit </p><p> Feedback is the breakfast of champions. Ken Blanchard, business consultant </p><p>http://www.catl.uwa.edu.au/resources/assessmenthttp://www.catl.uwa.edu.au/resources/assessmenthttp://www.heacademy.ac.uk/resources/detail/assessment/feedback-resourceshttp://www.heacademy.ac.uk/resources/detail/assessment/feedback-resources</p></li><li><p>2 REd Teaching Resource for Rural Clinical Educators, Issue 17 March 2012 </p><p>The term feedback has a range of </p><p>definitions, beginning with its origins in </p><p>engineering and neuroscience (output </p><p>signals integrated with input signals) to </p><p>feedback as reinforcement based on </p><p>operant and classical conditioning in </p><p>psychology [1]</p><p>. Teacher and learner alike </p><p>often view feedback as a negative act but </p><p>its potential to guide student learning is </p><p>significant. Feedback should be more than </p><p>pure assessment: it should assist students </p><p>to redirect their actions towards a better </p><p>outcome. Contemporary views of </p><p>feedback discuss it in a constructivist </p><p>sense, with knowledge construction </p><p>occurring as learners and supervisors </p><p>share feedback in action for learning [2]</p><p>. </p><p>Feedback can be given to a learner in a </p><p>number of different ways. It might be the </p><p>results of a formal test, the insights of </p><p>other students or part of a self-reflection </p><p>process. Eva et al. state that accurate </p><p>external feedback is crucial if one hopes </p><p>to facilitate improvement [3]</p><p>, and </p><p>emphasise that self-assessment alone is </p><p>too dependent on self-concept. Feedback </p><p>should be as close as possible to that </p><p>which will be experienced in actual </p><p>performance [1]</p><p>. Although the setting and </p><p>range of activities performed by learners </p><p>receiving feedback may vary, feedback </p><p>should be specific to the task in a </p><p>particular setting. </p><p>Written feedback is an important aspect of </p><p>guiding a students learning. In the clinical </p><p>years, feedback is mostly oral and based </p><p>on students clinical performance. End of </p><p>placement reports, mini-practical </p><p>examinations and tutor evaluations can all </p><p>involve formative (and summative) written </p><p>comments, and this has an important role </p><p>in assisting the students progress. </p><p>Generic comments (positive and </p><p>negative), although giving students a </p><p>general sense of how they have </p><p>performed, do not help to focus on </p><p>particular aspects of learning. </p><p>Providing written feedback to students </p><p>when clinical educators are working in </p><p>busy clinical settings can be difficult, but </p><p>meaningful feedback is essential [4] </p><p>to help </p><p>students modify and improve their </p><p>performance over time [5]</p><p>. Effective </p><p>feedback for learning needs to be forward-</p><p>looking (i.e. where and how am I going?) </p><p>and action-focussed with specific </p><p>strategies to help students with their </p><p>ongoing learning [2] </p><p>. Written feedback also </p><p>provides students with an individualised </p><p>record of their learning needs and </p><p>performance goals that they can revisit </p><p>after verbal feedback has taken place. It </p><p>has a different role to verbal feedback </p><p>presented during, or at the end of, a </p><p>clinical encounter and provides an </p><p>important mechanism for reflection and </p><p>self-regulated learning[2]</p><p>. </p><p>Students in community-based placements </p><p>often have multiple clinical supervisors in </p><p>diverse healthcare settings. Written </p><p>feedback that is forward-looking and </p><p>action-focussed is critical for meaningful </p><p>clinical learning. </p><p> 1. Grierson, L.E.M., We're talking about feedback...aren't we? Advances in Health Science Education, 2012. 17: p. 1-4. 2. Burke, D. and J. Pieterick, Giving Students Effective Written Feedback. 2010, England: McGraw-Hill Education. 192. 3. Eva, K.W., et al., Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes. Advances in Health Science Education, 2012. 17: p. 15-26. 4. Kogan, J.R., E.S. Holmboe, and K.E. Hauer, Tools for direct observation and assessment of clinical skills of medical trainees: a systematic review. JAMA, 2009. 302(12): p. 1316-1326. 5. Richardson, B.K., Feedback. Academic Emergency Medicine, 2004. 11(12): p. 1283.e1-1283.e5. </p><p>In Focus Forward-looking Feedback </p><p>Key terms </p><p>Feeding forward: </p><p>a process by </p><p>which students </p><p>indicate on an </p><p>assignment/task </p><p>how they have </p><p>attempted to follow </p><p>up on previous </p><p>feedback and how </p><p>they now seek </p><p>feedback on their </p><p>efforts. </p><p>Recursive </p><p>feedback: </p><p> specific feedback </p><p>on certain aspects </p><p>of tasks, allowing </p><p>students to </p><p>respond to </p><p>feedback and re-</p><p>do particular </p><p>sections. Tutors </p><p>check with </p><p>students that they </p><p>understand the </p><p>meaning of the </p><p>feedback before </p><p>redoing the </p><p>assessment. </p><p>3 REd Teaching Resource for Rural Clinical Educators, Issue 17 March 2012 </p><p>In Practice Using F.I.T. in clinical supervision </p><p>Key concepts </p><p>Holistic Rubric: </p><p> a framework of </p><p>criteria for </p><p>providing general </p><p>feedback on the </p><p>total process. </p><p>Analytical </p><p>Rubric: </p><p>a framework of </p><p>criteria for </p><p>providing feedback </p><p>on individual </p><p>components of the </p><p>process. </p><p>Enhanced </p><p>feedback: </p><p> a type of feedback </p><p>that uses goal </p><p>setting, and </p><p>evidence about a </p><p>persons current </p><p>achievements in </p><p>relation to that </p><p>goal, to provide </p><p>some </p><p>understanding of </p><p>how to bridge the </p><p>gap between the </p><p>two. </p><p>Figure 1: the FIT model </p><p>Figure 2: Feedback using FIT </p><p>Components of </p><p>FIT Explanation of Components </p><p>Framework Context of patient consultation with student </p><p>Identification Focussed acknowledgement of the students achievements </p><p>and why </p><p>To do Guided actions to progress student learning </p><p>There are many student feedback and assessment tools used in clinical education (e.g. </p><p>mini-CEX, end of placement assessments and tutor evaluation forms) that ask </p><p>supervisors to write comments about learners clinical performance. Without guidelines </p><p>on how to do this, comments are often too generic to be of specific help in the </p><p>progression of students learning. </p><p>F.I.T. is a simple and time effective model for recording written feedback. It has three </p><p>suggested components: a summary of the clinical encounter in which to contextualise </p><p>and evaluate student performance (the Framework); focussed Identification of student </p><p>achievements; and guiding To-do actions to progress students learning over time (see </p><p>figure 1). </p><p>The three parts of F.I.T. provide a structured model for clinical educators to present </p><p>written feedback in a brief but focussed way. Examples of written comments using FIT </p><p>are shown in Figure 2. </p><p>Components of </p><p>FIT Model </p><p>Written Feedback </p><p> Example 1 </p><p>Written Feedback </p><p>Example 2 </p><p>Framework </p><p>F: Constipation in young </p><p>male construction worker </p><p>F: Freehand excision with </p><p>primary closure, nylon sutures, </p><p>wound dressing </p><p>Identification </p><p>I: It was good that you let </p><p>the patient tell his story </p><p>without interrupting in first </p><p>minute </p><p>I: Appropriate needle holder </p><p>technique and safe </p><p>management of sharps </p><p>To do </p><p>T: Remember having two </p><p>other health points to </p><p>discuss adds value and </p><p>decreases dead time. Be </p><p>prescriptive when </p><p>suggesting taking fibre, </p><p>drinking water </p><p>T: Practice consistency of </p><p>needle depth to improve </p><p>wound approximation </p><p> (Harvey, Radomski and OConnor, 2011) </p>file:///U:/REd/Issue%2017/Issue%2017%20REd%20text.doc#_ENREF_1#_ENREF_1file:///U:/REd/Issue%2017/Issue%2017%20REd%20text.doc#_ENREF_2#_ENREF_2file:///U:/REd/Issue%2017/Issue%2017%20REd%20text.doc#_ENREF_3#_ENREF_3file:///U:/REd/Issue%2017/Issue%2017%20REd%20text.doc#_ENREF_1#_ENREF_1file:///U:/REd/Issue%2017/Issue%2017%20REd%20text.doc#_ENREF_4#_ENREF_4file:///U:/REd/Issue%2017/Issue%2017%20REd%20text.doc#_ENREF_5#_ENREF_5file:///U:/REd/Issue%2017/Issue%2017%20REd%20text.doc#_ENREF_2#_ENREF_2file:///U:/REd/Issue%2017/Issue%2017%20REd%20text.doc#_ENREF_2#_ENREF_2</li></ul>

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