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      Development of the Feedback Quality Instrument: a guide for health professional educators in fostering learner-centred discussions

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          Face-to-face feedback plays an important role in health professionals’ workplace learning. The literature describes guiding principles regarding effective feedback but it is not clear how to enact these. We aimed to create a Feedback Quality Instrument (FQI), underpinned by a social constructivist perspective, to assist educators in collaborating with learners to support learner-centred feedback interactions. In earlier research, we developed a set of observable educator behaviours designed to promote beneficial learner outcomes, supported by published research and expert consensus. This research focused on analysing and refining this provisional instrument, to create the FQI ready-to-use.


          We collected videos of authentic face-to-face feedback discussions, involving educators (senior clinicians) and learners (clinicians or students), during routine clinical practice across a major metropolitan hospital network. Quantitative and qualitative analyses of the video data were used to refine the provisional instrument. Raters administered the provisional instrument to systematically analyse educators’ feedback practice seen in the videos. This enabled usability testing and resulted in ratings data for psychometric analysis involving multifaceted Rasch model analysis and exploratory factor analysis. Parallel qualitative research of the video transcripts focused on two under-researched areas, psychological safety and evaluative judgement, to provide practical insights for item refinement. The provisional instrument was revised, using an iterative process, incorporating findings from usability testing, psychometric testing and parallel qualitative research and foundational research.


          Thirty-six videos involved diverse health professionals across medicine, nursing and physiotherapy. Administering the provisional instrument generated 174 data sets. Following refinements, the FQI contained 25 items, clustered into five domains characterising core concepts underpinning quality feedback: set the scene, analyse performance, plan improvements, foster learner agency, and foster psychological safety.


          The FQI describes practical, empirically-informed ways for educators to foster quality, learner-centred feedback discussions. The explicit descriptions offer guidance for educators and provide a foundation for the systematic analysis of the influence of specific educator behaviours on learner outcomes.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12909-021-02722-8.

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          Most cited references 75

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          Formative assessment and self‐regulated learning: a model and seven principles of good feedback practice

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            Feedback and Self-Regulated Learning: A Theoretical Synthesis

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              The Power of Feedback


                Author and article information

                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                12 July 2021
                12 July 2021
                : 21
                [1 ]GRID grid.1008.9, ISNI 0000 0001 2179 088X, Department of Medical Education, Faculty of Medicine, Dentistry and Health Sciences, , University of Melbourne, ; Melbourne, Victoria Australia
                [2 ]GRID grid.1002.3, ISNI 0000 0004 1936 7857, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, , Monash University, ; Melbourne, Victoria Australia
                [3 ]GRID grid.1002.3, ISNI 0000 0004 1936 7857, Faculty of Medicine, Nursing and Health Sciences, , Monash University, Monash Health, ; Melbourne, Victoria Australia
                [4 ]GRID grid.464664.2, ISNI 0000 0001 2161 5547, Royal Australian and New Zealand College of Psychiatrists, ; Melbourne, Victoria Australia
                [5 ]GRID grid.1002.3, ISNI 0000 0004 1936 7857, Faculty of Medicine, Nursing and Health Sciences, Monash University, ; Melbourne, Victoria Australia
                © The Author(s) 2021

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