Skip to main content

Advertisement

Log in

Feedback Credibility in Healthcare Education: a Systematic Review and Synthesis

  • Review
  • Published:
Medical Science Educator Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to systematically review and synthesize factors that influence learners’ perceptions of credibility when feedback is provided by an authority figure in a healthcare environment.

Methods

This study reviewed literature from medicine, psychology, and education using systematic review and qualitative synthesis methods. In a multi-step process, major electronic bibliographic databases were searched for relevant studies until October 2020.

Results

The search identified 9216 articles. A total of 134 abstracts underwent full-text review. Of these, 22 articles met inclusion criteria. The studies were heterogenous and the majority utilized a qualitative design with interviews and focus groups. A few studies employed mixed methodology (n = 2) and two studies used a quantitative design. Four main themes were identified: feedback characteristics, context of feedback, source credibility, and recipient characteristics.

Conclusion

As programs implement major educational change initiatives to create more formative assessment practices, feedback will become even more crucial. The four main themes identified are important factors that contribute to the perception of feedback credibility. While the factors are described independently, they may be viewed as interrelated and the association between these factors and feedback may be driven more by learning culture than each characteristic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig 1
Fig 2

Similar content being viewed by others

Data Availability

Data available upon request

References

  1. Nicol DJ, Macfarlane-Dick D. Formative assessment and self-regulated learning: a model and seven principles of good feedback practice. Stud High Educ. 2006;31(2):199–218.

    Article  Google Scholar 

  2. Ende J. Feedback in clinical medical education. JAMA. 1983;250(6):777–81.

    Article  Google Scholar 

  3. Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995;274(9):700–5.

    Article  Google Scholar 

  4. Epstein RM. Assessment in medical education. N Engl J Med. 2007;356(4):387–96. https://doi.org/10.1056/NEJMra054784.

    Article  Google Scholar 

  5. Paterson C, Paterson N, Jackson W, Work F. What are students’ needs and preferences for academic feedback in higher education? A systematic review. Nurse Educ Today. 2020;85:104236. https://doi.org/10.1016/j.nedt.2019.104236.

    Article  Google Scholar 

  6. Van de Ridder JMM, Stokking KM, McGaghie WC, ten Cate OTJ. What is feedback in clinical education? Med Educ. 2008;42(2):189–97. https://doi.org/10.1111/j.1365-2923.2007.02973.x.

    Article  Google Scholar 

  7. Norcini J. The power of feedback. Med Educ. 2010;44(1):16–7. https://doi.org/10.1111/j.1365-2923.2009.03542.x.

    Article  Google Scholar 

  8. Hattie J, Timperley H. The power of feedback. Rev Educ Res. 2007;77(1):81–112. https://doi.org/10.3102/003465430298487.

    Article  Google Scholar 

  9. Veloski J, Boex JR, Grasberger MJ, Evans A, Wolfson DB. Systematic review of the literature on assessment, feedback and physicians’ clinical performance: BEME Guide No. 7. Med Teach. 2006;28(2):117–28. https://doi.org/10.1080/01421590600622665.

    Article  Google Scholar 

  10. Watling C, Driessen E, van der Vleuten C, et al. Understanding responses to feedback: the potential and limitations of regulatory focus theory. Med Educ. 2012;46(6):593–603. https://doi.org/10.1111/j.1365-2923.2012.04209.x.

    Article  Google Scholar 

  11. Ramani S, Post SE, Konings K, Mann K, Katz JT, van der Vleuten C. “It’s just not the culture”: a qualitative study exploring residents’ perceptions of the impact of institutional culture on feedback. Teach Learn Med. 2017;29(2):153–61. https://doi.org/10.1080/10401334.2016.1244014.

    Article  Google Scholar 

  12. Sender-Liberman A, Liberman M, Steinert Y, McLeod P, Meterissian S. Surgery residents and attending surgeons have different perceptions of feedback. Med Teach. 2005;27(5):470–2.

    Article  Google Scholar 

  13. Bakke BM, Sheu L, Hauer KE. Fostering a feedback mindset: a qualitative exploration of medical students’ feedback experiences with longitudinal coaches. Academic Medicine. 2019;95(7):1057–65. https://doi.org/10.1097/acm.0000000000003012.

    Article  Google Scholar 

  14. Telio S, Regehr G, Ajjawi R. Feedback and the educational alliance: examining credibility judgements and their consequences. Med Educ. 2016;50(9):933–42. https://doi.org/10.1111/medu.13063.

    Article  Google Scholar 

  15. Watling C, Driessen E, Vleuten CPM, Lingard L. Learning culture and feedback: an international study of medical athletes and musicians. Med Educ. 2014;48(7):713–23. https://doi.org/10.1111/medu.12407.

    Article  Google Scholar 

  16. Weaver MR. Do students value feedback? Student perceptions of tutors’ written responses. Assess Eval High Educ. 2006;31(3):379–94. https://doi.org/10.1080/02602930500353061.

    Article  Google Scholar 

  17. Murdoch-Eaton D, Sargeant J. Maturational differences in undergraduate medical students’ perceptions about feedback. Med Educ. 2012;46(7):711–21. https://doi.org/10.1111/j.1365-2923.2012.04291.x.

    Article  Google Scholar 

  18. Lefroy J, Watling C, Teunissen PW, Brand P. Guidelines: the do’s, don’ts and don’t knows of feedback for clinical education. Perspect Med Educ. 2015;4(6):284–99. https://doi.org/10.1007/s40037-015-0231-7.

    Article  Google Scholar 

  19. Watling C, Driessen E, Vleuten CPM, Vanstone M, Lingard L. Beyond individualism: professional culture and its influence on feedback. Med Educ. 2013;47(6):585–94. https://doi.org/10.1111/medu.12150.

    Article  Google Scholar 

  20. Sargeant J, Mann K, Sinclair D, Van der Vleuten C, Metsemakers J. Understanding the influence of emotions and reflection upon multi-source feedback acceptance and use. Adv Health Sci Educ Theory Pract. 2008 Aug;13(3):275–88. https://doi.org/10.1007/s10459-006-9039-x.

    Article  Google Scholar 

  21. Watling C, Driessen E, van der Vleuten CPM, Lingard L. Learning from clinical work: the roles of learning cues and credibility judgements. Med Educ. 2012;46(2):192–200. https://doi.org/10.1111/j.1365-2923.2011.04126.x.

    Article  Google Scholar 

  22. Stroud L, Sibbald M, Richardson D, McDonald-Blumer H, Cavalcanti R. Feedback credibility in a formative postgraduate objective structured clinical examination: effects of examiner type. J Grad Med Educ. https://doi.org/10.4300/JGME-D-17-00578.1 Published 2020. Accessed Oct 31, 2020.

  23. Archer J. State of the science in health professional education: effective feedback.

  24. Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Inf Libr J. 2009;26(2):91–108. https://doi.org/10.1111/j.1471-1842.2009.00848.x.

    Article  Google Scholar 

  25. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed1000097.

    Article  Google Scholar 

  26. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.

    Article  Google Scholar 

  27. Bing-You R, Paterson J. Feedback falling on deaf ears: residents’ receptivity to feedback tempered by sender credibility. Med Teach. 1997;19(1):40. https://doi.org/10.3109/01421599709019346.

    Article  Google Scholar 

  28. Duijn CCMA, Welink LS, Mandoki M, ten Cate OTJ, Kremer WDJ, Bok HGJ. Am I ready for it? Students’ perceptions of meaningful feedback on entrustable professional activities. Perspect Med Educ. 2017;6(4):256–64. https://doi.org/10.1007/s40037-017-0361-1.

    Article  Google Scholar 

  29. Watling CJ, Kenyon CF, Zibrowski EM, Schulz V, Goldszmidt MA, Singh I, et al. Rules of engagement: residents’ perceptions of the in-training evaluation process. Acad Med. 2008;83(10 Suppl):S97–100. https://doi.org/10.1097/ACM.0b013e318183e78c.

    Article  Google Scholar 

  30. McPhee S, Phillips NM, Ockerby C, Hutchinson AM. Multisource feedback to graduate nurses: a multimethod study. J Clin Nurs. 2017 Nov;26(21-22):3442–56. https://doi.org/10.1111/jocn.13710.

    Article  Google Scholar 

  31. Fu RH, Cho YH, Quattri F, Monrouxe LV. ‘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. BMJ Open. 2019;9(1):e024425. https://doi.org/10.1136/bmjopen-2018-024425.

    Article  Google Scholar 

  32. Sargeant J, Eva KW, Armson H, Chesluk B, Dornan T, Holmboe E, et al. Features of assessment learners use to make informed self-assessments of clinical performance. Med Educ. 2011 Jun;45(6):636–47. https://doi.org/10.1111/j.1365-2923.2010.03888.x.

    Article  Google Scholar 

  33. Dijksterhuis MGK, Schuwirth LWT, Braat DDM, Teunissen PW, Scheele F. A qualitative study on trainees’ and supervisors’ perceptions of assessment for learning in postgraduate medical education. Med Teach. 2013;35(8). https://doi.org/10.3109/0142159X.2012.756576.

  34. Eva KW, Armson H, Holmboe E, Lockyer J, Loney E, Mann K, et al. Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes. Adv Health Sci Educ Theory Pract. 2012;17(1):15–26. https://doi.org/10.1007/s10459-011-9290-7.

    Article  Google Scholar 

  35. Ramani S, Könings K, Mann KV, van der Vleuten C. Uncovering the unknown: a grounded theory study exploring the impact of self-awareness on the culture of feedback in residency education. Med Teach. 2017;39(10):1065–73. https://doi.org/10.1080/0142159X.2017.1353071 Epub 2017 Jul 25.

    Article  Google Scholar 

  36. Moroz A, Horlick M, Mandalaywala N, Stern DT. Faculty feedback that begins with resident self-assessment: motivation is the key to success. Med Educ. 2018 Mar;52(3):314–23. https://doi.org/10.1111/medu.13484.

    Article  Google Scholar 

  37. Sargeant J, Armson H, Chesluk B, Dornan T, Eva K, Holmboe E, et al. The processes and dimensions of informed self-assessment: a conceptual model. Academic Medicine. 2010;85(7):1212–20. https://doi.org/10.1097/acm.0b013e3181d85a4e.

    Article  Google Scholar 

  38. Poulos A, Mahony MJ. Effectiveness of feedback: the students’ perspective. Assess Eval High Educ. 2008;33(2):143–54. https://doi.org/10.1080/02602930601127869.

    Article  Google Scholar 

  39. Manzone J, Tremblay L, You-Ten KE, et al. Task-versus ego-oriented feedback delivered as numbers or comments during intubation training. Med Educ. 2014;48(4):430–40. https://doi.org/10.1111/medu.12397.

    Article  Google Scholar 

  40. Ferguson J, Wakeling J, Bowie P. Factors influencing the effectiveness of multisource feedback in improving the professional practice of medical doctors: a systematic review. BMC Med Educ. 2014;14:76. https://doi.org/10.1186/1472-6920-14-76.

    Article  Google Scholar 

  41. Urquhart LM, Rees CE, Ker JS. Making sense of feedback experiences: a multi-school study of medical students’ narratives. Med Educ. 2014;48(2):189–203. https://doi.org/10.1111/medu.12304.

    Article  Google Scholar 

  42. Lizzio A, Wilson K, MacKay L. Managers’ and subordinates’ evaluations of feedback strategies: the critical contribution of voice1. Journal of Applied Social Psychology. 2008;38:919–46.

    Article  Google Scholar 

  43. Lockyer J, Carraccio C, Chan M-K, Hart D, Smee S, Touchie C, et al. Core principles of assessment in competency-based medical education. Med Teach. 2017;39(6):609–16. https://doi.org/10.1080/0142159X.2017.1315082.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

CD and SC conceived and planned the study. CD and KB performed the data collection and analysis, and wrote the manuscript. SC supervised the project.

Corresponding author

Correspondence to Cecilia M. Dai.

Ethics declarations

Conflict of Interest

The authors declare that there are no conflicts of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(DOCX 15 kb)

ESM 2

(DOCX 30 kb)

ESM 3

(DOCX 17 kb)

ESM 4

(DOCX 59 kb)

ESM 5

(DOCX 27 kb)

ESM 6

(DOCX 14 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dai, C.M., Bertram, K. & Chahine, S. Feedback Credibility in Healthcare Education: a Systematic Review and Synthesis. Med.Sci.Educ. 31, 923–933 (2021). https://doi.org/10.1007/s40670-020-01167-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40670-020-01167-w

Keywords

Navigation