Abstract
Feedback is considered important to acquire clinical skills. Research evidence shows that feedback does not always improve learning and its effects may be small. In many studies, a variety of variables involved in feedback provision may mask either one of their effects. E.g., there is reason to believe that the way oral feedback is framed may affect its effect if other variables are held constant. In a randomised controlled trial we investigated the effect of positively and negatively framed feedback messages on satisfaction, self-efficacy, and performance. A single blind randomised controlled between-subject design was used, with framing of the feedback message (positively–negatively) as independent variable and examination of hearing abilities as the task. First year medical students’ (n = 59) satisfaction, self-efficacy, and performance were the dependent variables and were measured both directly after the intervention and after a 2 weeks delay. Students in the positively framed feedback condition were significantly more satisfied and showed significantly higher self-efficacy measured directly after the performance. Effect sizes found were large, i.e., partial η 2 = 0.43 and η 2 = 0.32 respectively. They showed a better performance throughout the whole study. Significant performance differences were found both at the initial performance and when measured 2 weeks after the intervention: effects were of medium size, respectively r = −.31 and r = −.32. Over time in both conditions performance and self-efficacy decreased. Framing the feedback message in either a positive or negative manner affects students’ satisfaction and self-efficacy directly after the intervention be it that these effects seem to fade out over time. Performance may be enhanced by positive framing, but additional studies need to confirm this. We recommend using a positive frame when giving feedback on clinical skills.
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Acknowledgments
The authors are grateful to the Skills lab of the UMCU, especially to Jaap Buis, MD, and Jantien de Loor, MD, who offered us the possibility to use part of their teaching moments to carry out this study, and to Carlos Kok and Niels Morgenstern for the technical assistance during the experiment. Further we acknowledge Fred Tromp for his useful comments on developing the observational checklists. We would like to thank Dawi van der Stap who provided the feedback, Marijke Sterman, who fulfilled the role of the Standardized Patient. We would also like to thank Bill McGaghie for his comments on the manuscript.
Ethical standard
This study was deemed exempt of ethical approval by the Medical Ethics Review Committee of the UMCU.
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van de Ridder, J.M.M., Peters, C.M.M., Stokking, K.M. et al. Framing of feedback impacts student’s satisfaction, self-efficacy and performance. Adv in Health Sci Educ 20, 803–816 (2015). https://doi.org/10.1007/s10459-014-9567-8
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DOI: https://doi.org/10.1007/s10459-014-9567-8