ISHTIAQ AHMED

256-257

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Feedback is an important and integral constituent of medical teaching, as it enhances and encourages the student's knowledge, skills and professional performance. It is a process which comprises of communication of information, followed by reactions to such communication. In feedback, the specific information was given to the student about the difference between his observed performance and a given standard, with the target of achieving improvement in performance of the student1. The basic aim of feedback is helping students to achieve their goals in addition to the educational objectives, which aids in improvement of their performance 2,3. In the absence of feedback the students have to rely on self-assessment to determine, what has gone well and what needs improvement. Usually, this self-assessment fails to help in identifying learners' own strengths or weaknesses. Moreover, the absence of feedback may leads to misperception of approval of their performance among the students3. The potential of feedback can be maximized, provided the teacher is receptive to suggestions for change and willing to improve4. Feedback can be considered as constructive in the process of learning if it is delivered immediately and in a sensitive manner5,6. It is well observed that the students learn more effectively when peer feedback is incorporated an integral constituent of the overall

assessment5. Many researchers have reported the effectiveness of feedback as a mechanism to improve learning outcome7. Staff development is a key in increasing the teachers' comfort and skills in providing effective feedback4. It should be kept in mind that the processes of giving and receiving feedback are skills that can be acquired only with practice and should be conducted in a professional way. The training of the trainers regarding techniques of adult learning and how to give feedback to trainees are foremost requirements, if we want to integrate the concept of feedback in medical education. Moreover, the Interactive feedback is crucial in bringing about the professional development and overall improvement among students. The mentoring relationship between learner and teacher is vital in giving effective feedback. This can be achieved effectively if feedback is delivered in an appropriate setting with special emphasis on the performance and not on the individual. Importantly, the feedback should be specific and clear, delivered in soft non-judgmental language, should focus more on positive aspects, be descriptive rather than evaluative and should suggest measures for improvement. Moreover, it should acknowledge and reinforce their exemplary behaviour which will give them confidence in their skills, highlight areas requiring improvement and suggest measures for the same. A perfect outcome is only achieved if the sender and receiver of feedback work together as a team and help to achieve a better output for the students2,8. Sometimes, providing feedback to students or trainees can be challenging to even the most experienced teachers. Frequently, there is a mismatch between educators and learners perceptions of the adequacy and effectiveness of feedback. In reality, despite the consensus that feedback is an important tool for improved learning capabilities, the literature review on feedback has revealed an increase in numbers of reports of dissatisfaction both from learners as well as educators aspects9. Moreover, majority of educators are familiar with the concept and principles of giving feedback but usually it remains underused, probably because the teacher is concerned about the impact of negative feedback upon the trainee and upon the future trainee-trainer relationship10. In view of recent changes in medical working patterns, we have to create newer opportunities to observe trainees and thus provide quality and timely feedback to facilitate learning of students.

 

To my view, every medical college/institute should establish a medical education unit in their institute. The members of medical education unit must be trained in conducting faculty development programs as a part of medical education unit activities. Regular workshops/courses should be organised as a part of faculty development in the presence of external or a third party observers. These workshops can be used effectively as a platform to inculcate the skills of giving effective feedback and to emphasize the fact that feedback are skills that can be acquired only with repetitive practice. The institution should also develop a process for monitoring the feedback process in lectures, practicals or in clinical rotations. In addition, video recording of the feedback sessions can prove a very useful technique for monitoring a feedback session. Teachers should have a prime responsibility to provide meaningful feedback to learners and at the same time learners should expect and seek feedback. To conclude, interactive feedback is indispensable in bringing about professional development and overall improvement in medical profession. It provides learners with information on his past performances so that future performance can be improved. In the absence of adequate feedback, good performance is not recognized and problems with regard to clinical competence go uncorrected for long periods of time. So there is a need for better and complete understanding of the processes of giving, receiving, interpreting, and using feedback as a basis for real progress toward effective and meaningful evaluation.