the challenge of giving written thesis feedback to nursing students
TRANSCRIPT
Nurse Education Today 34 (2014) 1343–1345
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Nurse Education Today
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Contemporary Issues
The challenge of giving written thesis feedback to nursing students
Hanna Tuvesson ⁎, Gunilla BorglinSchool of Health Science, Blekinge Institute of Technology, SE-37971 Karlskrona, Blekinge, SwedenFaculty of Health and Society, Malmö University, SE-20506 Malmö, Sweden
⁎ Corresponding author at: Faculty of Health Science, DInstitute of Technology, SE-37179 Karlskrona, Sweden. Te
E-mail address: [email protected] (H. Tuvesson)
http://dx.doi.org/10.1016/j.nedt.2014.07.0030260-6917/© 2014 Elsevier Ltd. All rights reserved.
s u m m a r y
a r t i c l e i n f oArticle history:Accepted 3 July 2014
Keywords:Bachelor of Science in NursingNursing educationThesisWritten feedback
Providing effectivewritten feedback on nursing student's assignments can be a challenging task for any assessor.Additionally, as the student groups tend to become larger, written feedback is likely to gain an overall moreprominent position than verbal feedback. Lack of formal training or regular discussion in the teaching facultyabout the skill set needed to provide written feedback could negatively affect the students' learning abilities. Inthis brief paper, we discuss written feedback practices, whilst using the Bachelor of Science in Nursing thesisas an example. Our aim is to highlight the importance of an informed understanding of the impact writtenfeedback can have on students. Creating awareness about this can facilitate the development of more strategicand successful written feedback strategies. We end by offering examples of some relatively simple strategiesfor improving this practice.
epartment of Health, Blekingel.: +46 455 385417..
© 2014 Elsevier Ltd. All rights reserved.
Introduction
Two decades after a significant shift, which took the training ofnurses out of the hospital and into higher educational institutions(HEIs), teaching faculty and nursing students still struggle to differentlevels with the ‘theory–practice’ divide (Whitehead, 2002). As educa-tors, we are striving to build bridges, whilst students try to get thehang of academic writing (cf. Whitehead, 2002) and nursing researchin the shape of a bachelor thesis. As one important part of thetransforming journey towards becoming an academic discipline, manynurse education programmes in Europe, including Sweden, are nowbaccalaureate degree programmes. This means that besides clinicalplacements, academicwriting and research education are also employed,taught and assessed throughout the nursing programme.
The final academic pièce de résistance in the nursing programmeis the bachelor thesis, in this context a document (about 20,000 wordsfollowing IMRAD) submitted in support of candidature for an academicdegree that presents the author's research and findings (hereinafterreferred to as thesis). The thesis can, for example, be conducted as aliterature review or as a smaller empirical study such as an interviewstudy. The thesis is graded by pre-set evaluation criteria, which cancover; Problematisation/introduction e.g. relevance, originality andcurrency of the research question, the research question's link toearlier research, and the author's ability to demonstrate the theoreticaland practical contributions of the thesis; theoretical frame of reference
e.g. the scientific currency of the frame of reference, and the extentto which the author interacts with the theories used and not onlycites books and papers; method e.g. the relevance of chosen methodsto answering the research question, the author's description of and argu-ments for the chosen methods and the author's awareness of thestrengths andweaknesses of the chosenmethods. The evaluation criteriawill also cover headings such as result, discussion and conclusion and over-all impression of the thesis.
The writing up of the thesis is often the student's first individualengagement with the research process and nursing research. However,the requirement for conferring the Bachelor of Science in Nursing (BSN)together with professional accreditation to become a nurse is still a con-troversial issue. Findings from research (Lindberg et al., 2012) have im-plied that nursing students regard the responsibility for research anddevelopment of care as belonging to someone else. Thus, the integrationof the clinical practice and science during the nursing education is achallenge in general. Regardless, we propose that depending on howthis engagement unfolds, the student's attitude towards nursing scienceis likely to be influenced. Our experience is that it is at thismoment, thatthe theory–practice divide is either cemented or disintegrated. Insightand knowledge into how educators prevent this concretion, makingthesis writing into a positive experience, seems to be an importantgoal. We propose that the process and the end product (i.e. the thesis)are likely to be influenced by the feedback received.
Fundamental actors in the thesis process, beyond the supervisors,are the assessors. In Sweden, registered nurses holding a master's de-gree in nursing (lecturers) make up one part of the teaching faculty.Many of these have also trained as teachers. These lecturers supervisethe nursing students during their work on the thesis. The other part of
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the faculty is made up of the senior lecturers, registered nurses holdinga PhD in nursing. Fewer of them are in general trained as teachers.Regulations state that senior lecturers will assess and grade the nursingstudents' thesis. Consequently, oral and written feedback to students isa common and important part of the senior lecturers' daily work.
Where and why can the thesis as part of nursing education gowrong? Receiving corrections is the norm rather than the exception.Therefore, the student is expected to revise and resubmit in accordancewith assessors' written (and at times oral) feedback before the finalgrading is completed. Consequently, how assessors give feedback andthe type and quality of the feedback given can both play a significantrole for students' knowledge acquisition. A negative outcome heremight hinder progress and development of the thesis. But, for example,it might also become a barrier to students' willingness to take onnursing science in clinical practice at a later stage, especially sincesome students, in our experience, have a tendency to make a hugeleap of faith, equating the formality of academic writing with nursingscience and research (Borglin and Fagerström, 2012). Thus, we knowthat written feedback is complex (Burke and Pietrick, 2010), and thatthe ability to give effective feedback is a skill, which the teaching facultymay still need to master (cf. Brookhart, 2008). On top of this, we alsoknow that both students andmembers of teaching faculty can be dissat-isfied with written feedback practice (Nicol, 2010).
It is worth noting that previous literature has focussed on exploringassessments of nursing students' clinical competence; several of thesestudies have been published in this journal, amongst other settings.Therefore, we would like to propose that it is timely to focus on howwe assess students' academic coursework, particularly in terms of theassessors' written feedback to nursing students as a part of the thesisprocess. It is our view that a lack of training on how to givewritten feed-back, together with the lack of public discussion and reflection on thispractice, can act as a barrier to providing effective and objective writtenfeedback to students. Burke and Pietrick (2010) suggest that we couldimprove comments and feedback if we understand our own currentfeedback practices. In this paper, we will discuss written feedback, andput forward some strategies on how to develop this practice.
Giving Written Feedback
Brennan (1995) argues that writing assignments (essays) are a corecomponent of assessment in nursing education. Different genres ofessay writing can function as a means for students to communicatetheir ideas, aswell as a way to illustrate their understanding of a subjector topic. Writing assignments can also be viewed as a means forstudents to meet course objectives. Writing has also been suggested tobe an important component in demonstrating scholarship (Whitehead,2002), and written communication skills are of importance for nursingpractice (Troxler et al., 2011). Writing is often considered to be a chal-lenging task (Covic and Jones, 2008), and many nursing students areknown to struggle with the process of writing (Whitehead, 2002). InSweden, despite having lived through three years of different categoriesof writing assignments, the bachelor thesis is often the nursing student'sfirst ‘hands-on’ experience of the research process in combination withacademic writing ad gravis. It therefore seems reasonable to assumethat how the students are guided in this process by their supervisors(the lecturers) together with the assessors (the senior lecturers) writtenfeedback before final grading i.e. the process, can have a substantial im-pact on the final product i.e. the thesis.
The concept of feedback is complex and used in many different con-texts and areas. Hattie and Timperley (2007) conceptualised feedbackas information provided by an agent, for example a teacher, regardingaspects of an individual's performance or understanding. There are dif-ferent ways of giving written feedback. Customary approaches includecomments directly in the thesis, a written summary, a cover sheet or acombination of these (Brookhart, 2008). The main aim of all feedbackshould be to benefit the student (Brennan, 1995), for example, by
reducing possible gaps between current understandings, performancesand goals (Hattie and Timperley, 2007). However, receiving writtenfeedback can be experienced as a challenge due to the fact that it feelsmore definitive to the student than verbal feedback. In the best of allpossible worlds both types of feedback should be provided. However,since the student groups, regardless of education, now tend to becomelarger and larger this kind of feedback practice becomes more or lessimpossible (cf. Nicol, 2010). In one of a few studies investigating the ex-periences of feedback amongst student nurses, Whitehead (2002)found that feedback was experienced as inconsistent and confusing.On the other hand, in a study by Borglin and Fagerström (2012) nursingstudents reported thatwritten feedback received hadmainly focused onwriting convention and style and not the subject content. The assessorsneed to bear inmind that thewritten feedback can have amajor impacton students. Hence, feedback not only can have a favourable influenceon students and their ability to revise and learn, but also can negativelyaffect their confidence and motivation, which may result in negativelong-term consequences (Burke and Pietrick, 2010).
One important aspect to consider is that the manner in which thefeedback is received and understood also depends on the student.Covic and Jones (2008) argue that student attitudes to learning influ-ence the type of feedback they may find useful. Moreover, and as men-tioned earlier, many nursing students experience academic writing asan obstacle to overcome and consider that possessing academic writingskills is of very little use to them in clinical practice (Whitehead, 2002).These factors put further pressure on assessors in terms of the designand content of their written feedback. It can be argued that writtenfeedback must be understood by the student in order to be effective.However, in many cases, the senior lecturers – the assessor – has noprior knowledge of the student whose thesis he/she is assessing andgiving feedback on. This implies that giving customised feedback foreach student, which addresses the student's progress, and developmentover time is an impossible task, even ifwe know that thiswould certain-ly support the student's learning.
Giving qualitative written thesis feedback, which is understood bythe student and leads to improvement and learning, is often a real chal-lenge. The ability to give effective feedback requires great skill (Hattieand Timperley, 2007); yet, most assessors have been left alone to figureout how to give effective and objective feedback (Burke and Pietrick,2010). Accordingly, many of us may feel insecure about how to givegood written feedback. Some may even use feedback merely as a wayto justify grades. Burke and Pietrick (2010) suggest that there mightbe a risk that assessors take the role as the expert controlling the thesisrather than prompting students to learn. Interestingly enough, Baroffioet al. (2007) found that very few nurse educators actually thoughtthat they needed more training and/or better practice in giving writtenfeedback. With this in mind we would like to offer examples of somerelatively simple strategies for improving this practice;
• Offer a resume or a summing up of the thesis strengths andweaknesseswhilst mainly focusing on the content. Concentrating feedback on thisaspect is, according to Burke and Pietrick (2010), the best and mosteffective approach.
• Offer constructive feedback through explicit elaborated examples andsuggestions on how to improve the thesis. Brookhart (2008) andBurke and Pietrick (2010) support such a strategy and state that theassessors need to strive to give specific, clear and constructivefeedback.
• Offer explanations for the critique given. Brookhart (2008) arguesthat feedback should contain explanations for the critique givenand that descriptive feedback is preferable.
• Offer a simple language and use a respectful tone. This is a veryimportant strategy according to Brookhart (2008), who furthersuggests that complex words and sentences might be difficult forthe students to understand and consequently such an approach islikely to backfire.
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• Offer feedback that can be clearly connected back to the evaluationcriteria for the thesis. Feedback should be goal oriented and bridgethe gap between performance and goals (Brookhart, 2008; Burkeand Pietrick, 2010).
Summing Up
Assessing and giving effective written thesis feedback is challenging.The summarised strategies offered in this paper are in line with therecommendations in the literature. Besides the suggested strategies,another approach could be to use actual examples of written feedbackas a departure point for discussions in the teaching faculty. However,to be able to understand the impact written feedback can have onstudents' ability to acquire the relevant skills and knowledge requiredto pass their exam, more research into this practice is clearly needed.To be truly student-centred, researchwill need to focus onwritten feed-back practice from both the perspectives of faculty and students. Theknowledge stemming from this type of research could facilitate asses-sors to ‘up the ante’ concerning their skills in written feedback. In themeantime, it is apparent that we need to openly discuss and reflectupon our current practices concerning this type of feedback. Adoptingsuch an approach is likely to help us to improve our feedback skillsand better support student learning. We believe that if we focus onthis type of assessment and become as skilled at it as we are at assessingstudents' clinical competence,wemight be able to tear downone or twolayers of bricks from the long lasting ‘theory–practice’ bulwark.
Acknowledgements and Funding
The Faculty of Health Science, Department of Health at BlekingeInstitute of Technology and the Faculty of Health and Society atMalmö University supported HT and GB.
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