A descriptive study of clinicians’ experiences of giving feedback to final year medical students
| dc.contributor.advisor | Blitz, Julia | en_ZA |
| dc.contributor.advisor | Schmutz, A. M. S. | en_ZA |
| dc.contributor.author | Mouton, Jannie | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Health Systems and Public Health. | en_ZA |
| dc.date.accessioned | 2024-02-06T08:48:58Z | |
| dc.date.accessioned | 2024-04-26T23:24:18Z | |
| dc.date.available | 2024-02-06T08:48:58Z | |
| dc.date.available | 2024-04-26T23:24:18Z | |
| dc.date.issued | 2024-03 | |
| dc.description | Thesis (MPhil)--Stellenbosch University, 2024. | en_ZA |
| dc.description.abstract | ENGLISH SUMMARY: The translation of the science of learning to improve models of training should form part of the delivery of clinical services and the process of transforming health systems. Though good clinical teaching is at the centre of medical education, there are concerns about maintaining this in current pressured healthcare environments. Research revealed that feedback on student performance plays a crucial part of learning in the workplace and thus also as part of educational programs in health professions education. The importance of an educator’s role in feedback and how that role can improve achievement of learning outcomes via quality feedback have been reported. We are also reminded that experience-based learning of medical students plays an important role in competency-based medical curricula, and its value depends greatly on how clinicians and students use the exposure to achieve learning. Furthermore, it identified inadequate training in the giving of feedback as one of the key shortcomings of experience-based learning. Despite the importance of educators’, or in this case, clinicians’ roles in feedback and learning outcomes, my experience is that many of the clinicians, in our and in neighbouring training hospitals, have not been properly orientated or trained with regard to their responsibilities and simply had to assume this role of a clinician teacher as part of their duties. This experience is corroborated by research, who informs us that clinicians are sometimes unclear on how their teaching fits into the curriculum and that they feel unprepared for the tasks of giving feedback and of teaching and highlighted the need for faculty development of this area. The aim of this study, therefore, was to gain a better understanding of the perceptions of clinicians on giving feedback by exploring their experiences of doing this with final-year year medical students at rural teaching sites of Stellenbosch University, and in doing so, finding ways to improve the giving of feedback. This was an interpretivist study, generating qualitative data and using thematic analysis to analyse the data. This study was conducted at two rural district hospitals in the Western Cape (WC) Province of South Africa, namely that of Hermanus and Ceres, which form part of the LIC model of training of the Ukwanda Rural Clinical School of Stellenbosch University. Data was generated by conducting interviews with the clinicians, who are involved in teaching at these hospitals. Individual perspectives and experiences were explored by using a semi-structured interview schedule for the asking of the questions. Five overarching themes were developed from the findings of the study, and these highlight the important roles and responsibilities that both the clinical teacher and the student have in the feedback process, as well as the different aspects involved in the process of the giving of feedback itself. The overarching themes are the importance of relationship building between medical officer and student, the environment in which the feedback occurs, clinicians’ general experiences of feedback, more personal experiences of giving feedback and fifthly, considerations with regard to students, as the other party in the feedback process. Probably the most significant point that emerged was the importance of establishing a relationship between the medical officer and the student, and that connection between the two parties needed to take place before a relationship could be built. This was also crucial for the establishment of mutual trust and for feedback to translate into learning for the student. It was also revealed that this relationship or connection should entail a two-way discussion and was not a one-way monologue where the teacher or clinician just commented on what the student did wrong, as was very much a practice in the past. What was interesting was the various ways in which the process of feedback was described. According to some responses, the feedback process was something that should be specific and focused, but also should be carefully and skillfully done and therefore required thinking, preparation and more efficient orientation of the clinical teacher. It is well summarised in this quote: “Feedback should be a learning opportunity and not a scoring episode”. The need for training and capacity building for clinicians to improve the quality of the feedback they gave was another aspect that emerged almost unanimously from the data. The most prominent challenges identified in giving feedback that translated to learning were sufficient time and appropriate space to deliver the feedback. The envisaged contribution of the study is that gaining a better understanding of how clinicians experience giving feedback, could contribute towards planning and implementing appropriate training to improve the capacity of clinicians to provide feedback and therefore potentially improve quality of teaching and learning on this platform. | en_ZA |
| dc.description.abstract | AFRIKAANSE OPSOMMING: Navorsing lig ons in dat die oordrag van die wetenskap van leer om die modelle van onderrig te verbeter, deel behoort uit te maak van die lewering van kliniese dienste en die proses om die gesondheidsdienste te transformeer. Terwyl goeie kliniese onderrig die kern uitmaak van mediese opleiding, is daar wesenlike kommer oor die vermoe om dit te handhaaf in die huidige klimaat van gesondheidsdienste wat onder druk verkeer. Terugvoer oor studenteprestasie speel ‘n baie belangrike rol in leer in die werksplek, en dus ook in die opvoedkundige programme van gesondheidsonderrig. Die belangrikheid van die rol van ‘n opvoeder in terugvoer is reeds bekend en hoe daardie rol kan bydra tot die verbetering van leeruitkomste deur middel van kwaliteit terugvoer. In ‘n poging om beter insigte te bekom oor die belangrikheid van die gee van terugvoer, word ons daaraan herinner dat onderrig van mediese studente, wat gebaseer is op ondervinding, ‘n belangrike rol speel in kompetente mediese kurrikulums en dat die waarde daarvan grootliks afhang van hoe studente en klinici die blootstelling gebruik om by te dra tot ‘n leerervaring. Voorts was dit identifiseer dat onvoldoende opleiding in die gee van terugvoer een van die belangrikste kortkominge is in ondervinding-gebaseerde leer. Ten spyte van die belangrikheid van n opvoeder, of in hierdie geval, n klinikus se rol in terugvoer en leeruitkomste, is my ervaring dat vele van die klinici in ons en naburige opleidingshospitale nie behoorlik georienteer of opgelei is in verband met hulle opleidingsverantwoordelikhede in hierdie verband nie en hulle is eenvoudig genoodsaak om die rol van kliniese onderwyser te aanvaar as deel van hul verantwoordelikhede. Klinici ervaar soms onduidelikheid oor hoe hul onderrig in die kurrikulum inpas, en terselfdertyd voel hulle onvoorbereid vir die taak van die gee van terugvoer en onderrig, wat die behoefte beklemtoon vir fakulteitsontwikkeling in hierdie area. Die doelwit van hierdie studie is dan om die ervaringe van klinici in die gee van terugvoer aan finale-jaar mediese studente in landelike opleidingsareas van Stellenbosch Universiteit (SU), te ondersoek en beter te verstaan in n poging om die kwaliteit van die gee van terugvoer te verbeter. Hierdie was ‘n interpretivistiese studie, wat kwalitatiewe data gegenereer het en gebruik gemaak het van tematiese analise om dit te analiseer. Die studie is uitgevoer in twee landelike distrikshospitale van die Wes-Kaapse Provinsie van Suid Afrika, naamlik Hermanus- en Ceres-hospitale, wat deel uitmaak van die longitudinale geintegreerde klerkskap (LIC) model van opleiding van die Ukwanda Landelike Kliniese Skool van SU. Die data is ingesamel deur middel van onderhoude wat gevoer is met klinici, wat betrokke is by die opleiding van studente by Hermanus- en Ceres-hospitale, waar individuele perspektiewe en ondervindings ondersoek is deur gebruik te maak van n semi-gestruktureerde raamwerk van vrae. Die bevindinge van die studie het vyf oorkoepelende temas geidentifiseer, wat die belangrike rolle en verantwoordelikhede na vore laat kom het wat beide die klinikus en die student het in die terugvoerproses, sowel as die verskillende aspekte betrokke in die proses van terugvoer self. Die oorkoepelende temas is die belangrikheid om vehoudings tussen die mediese beampte en die student te ontwikkel, die omgewing waarbinne die terugvoerproses plaasvind en derdens, die klinici se algemene ervaringe van terugvoer, meer persoonlike ervaringe van die terugvoerproses en vyfdens, oorwegings met betrekking tot die student, as die ander party in die terugvoerproses. Die mees insiggewende bevinding wat na vore gekom het was die belangrikheid om n verhouding te ontwikkel tussen die student en mediese beampte en dat so n konneksie behoort plaas te vind voordat ‘n verhouding ontwikkel kan word. Dit is ook van kardinale belang in die skep van n wederkerige vertrouensverhouding en vir leersame terugvoer. Dit het ook na vore gekom dat die verhouding of konneksie n tweeledige gesprek behoort te behels, en nie ‘n eenrigting monoloog waar die klinikus slegs kommentaar lewer op wat die student verkeerd gedoen het nie, soos die gewoonte was in die verlede. Die behoefte aan opleiding en die bou van kapasiteit vir klinici om die kwaliteit van die gee van terugvoer te verbeter was nog n aspek wat bykans eenparig uit die data verkry kon word. Die mees prominente uitdagings wat geidentifiseer is in die gee van terugvoer wat leer tot gevolg gehad het, was genoegsame tyd en voldoende spasie om die terugvoer te kan gee. Wat verder opvallend was, was die verskillende maniere waarmee die terugvoerproses beskryf is. Volgens sekere menings is die terugvoerproses iets wat gefokus en spesifiek behoort te wees, maar wat met omsigtigheid en vaardigheid hanteer moet word en daarom ‘n mate van denke, voorbereiding en beter orientering van die klinikus vereis. ‘n Aanhaling van een van die onderhoude wat in Engels gevoer is, en wat dit goed opsom, is dat “terugvoer ‘n leerervaring en nie ‘n puntetoekenningsgeleentheid behoort te wees nie”. Die verwagte bydrae wat die studie kan maak is n verbeterde begrip van hoe klinici die gee van terugvoer aan studente ervaar. Dit sal ‘n bydrae kan maak tot die beplanning en implementering van toepaslike onderrig om die kapasiteit van klinici te verbeter om terugvoer te gee en wat vervolgens ook kan bydra tot ‘n verbetering van onderrig en leer op hierdie platform. | af_ZA |
| dc.description.version | Masters | |
| dc.format.extent | 81 pages ; includes annexures | |
| dc.identifier.uri | https://scholar.sun.ac.za/handle/10019.1/130597 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | |
| dc.rights.holder | Stellenbosch University | |
| dc.subject.lcsh | Communication in education | en_ZA |
| dc.subject.lcsh | Feedback (Psychology) | en_ZA |
| dc.subject.lcsh | Medicine -- Study and teaching | en_ZA |
| dc.subject.name | UCTD | |
| dc.title | A descriptive study of clinicians’ experiences of giving feedback to final year medical students | en_ZA |
| dc.type | Research assignment | en_ZA |
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