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      ‘I did not check if the teacher gave feedback’: a qualitative analysis of Taiwanese postgraduate year 1 trainees’ talk around e-portfolio feedback-seeking behaviours

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          Abstract

          Objectives

          Despite feedback being an extensively researched and essential component of teaching and learning, there is a paucity of research examining feedback within a medical education e-portfolio setting including feedback-seeking behaviours (FSBs). FSBs can be understood within a cost–value perspective. The objective of this research is to explore the factors that influence postgraduate year 1 (PGY1) trainee doctors’ FSBs via e-portfolios.

          Setting

          Postgraduate education provision in the largest teaching hospital in Taiwan.

          Participants

          Seventy-one PGY1s (66% male).

          Methods

          A qualitative semistructured one-to-one interview method was adopted. Interviews were audio recorded, transcribed verbatim, anonymised and checked for completeness. Data were analysed inductively via thematic framework analysis and deductively informed using FSB theory. The process comprised data familiarisation, identification of the themes, charting and data interpretation.

          Results

          Two main themes of FSB related and e-portfolio related were identified. We present the theme focussing on FSB here to which n=32 (22 males, 10 females) of the n=71 participants contributed meaningfully. Subthemes include factors variously affecting PGY1s’ positive and negative FSBs via e-portfolios at the individual, process and technological levels. These factors include learner-related (internal values vs social influence, forced reflection); teacher-related (committed educators vs superficial feedback); technology-related (face-saving vs lagging systems; inadequate user-interface) and process-related (delayed feedback, too frequent feedback) factors.

          Conclusions

          Our findings reveal the complexity of PGY1s’ FSBs in an e-portfolio context and the interaction of numerous facilitating and inhibiting factors. Further research is required to understand the range of facilitating and inhibiting factors involved in healthcare learners’ FSBs across different learning, social, institutional and national cultural settings.

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          Most cited references26

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          FEEDBACK-SEEKING IN INDIVIDUAL ADAPTATION: A RESOURCES PERSPECTIVE.

          S. Ashford (1986)
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            Systematic review of the literature on assessment, feedback and physicians' clinical performance: BEME Guide No. 7.

            There is a basis for the assumption that feedback can be used to enhance physicians' performance. Nevertheless, the findings of empirical studies of the impact of feedback on clinical performance have been equivocal. To summarize evidence related to the impact of assessment and feedback on physicians' clinical performance. The authors searched the literature from 1966 to 2003 using MEDLINE, HealthSTAR, the Science Citation Index and eight other electronic databases. A total of 3702 citations were identified. Empirical studies were selected involving the baseline measurement of physicians' performance and follow-up measurement after they received summaries of their performance. Data were extracted on research design, sample, dependent and independent variables using a written protocol. A group of 220 studies involving primary data collection was identified. However, only 41 met all selection criteria and evaluated the independent effect of feedback on physician performance. Of these, 32 (74%) demonstrated a positive impact. Feedback was more likely to be effective when provided by an authoritative source over an extended period of time. Another subset of 132 studies examined the effect of feedback combined with other interventions such as educational programmes, practice guidelines and reminders. Of these, 106 studies (77%) demonstrated a positive impact. Two additional subsets of 29 feedback studies involving resident physicians in training and 18 studies examining proxy measures of physician performance across clinical sites or groups of patients were reviewed. The majority of these two subsets also reported that feedback had positive effects on performance. Feedback can change physicians' clinical performance when provided systematically over multiple years by an authoritative, credible source. The effects of formal assessment and feedback on physician performance are influenced by the source and duration of feedback. Other factors, such as physicians' active involvement in the process, the amount of information reported, the timing and amount of feedback, and other concurrent interventions, such as education, guidelines, reminder systems and incentives, also appear to be important. However, the independent contributions of these interventions have not been well documented in controlled studies. It is recommended that the designers of future theoretical as well as practical studies of feedback separate the effects of feedback from other concurrent interventions.
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              How Are We Doing After 30 Years? A Meta-Analytic Review of the Antecedents and Outcomes of Feedback-Seeking Behavior

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                1 February 2019
                : 9
                : 1
                : e024425
                Affiliations
                [1] departmentChang Gung Medical Education Research Centre (CG-MERC) , Chang Gung Memorial Hospital Linkou Branch , Gueishan, Taoyuan, Taiwan
                Author notes
                [Correspondence to ] Professor Lynn V Monrouxe; monrouxe@ 123456me.com , lynnvm8@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-4275-7787
                http://orcid.org/0000-0002-4895-1812
                Article
                bmjopen-2018-024425
                10.1136/bmjopen-2018-024425
                6361414
                30782734
                ecc0ea19-5b90-471a-9155-5a737b2adcd5
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 26 May 2018
                : 20 November 2018
                : 03 December 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100007225, Ministry of Science and Technology;
                Funded by: FundRef http://dx.doi.org/10.13039/501100005795, Chang Gung Memorial Hospital, Linkou;
                Categories
                Medical Education and Training
                Research
                1506
                1709
                Custom metadata
                unlocked

                Medicine
                feedback,feedback-seeking behaviours,qualitative research,taiwan,technology enhanced learning

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