Exploring the enablers and inhibitors of feedback-seeking in learners
Arora, Harpreet Michelle
BACKGROUND: Feedback is one of the most effective influences in learning, but students often feel they receive insufficient useful feedback. However, most research into feedback considers learners to be passive recipients, when in reality students may proactively seek feedback. Feedback-seeking can overcome some challenges with feedback, improving its perceived value and increasing feedback-receptivity. As feedback-seeking behaviour develops as learners become more experienced, we need to consider how to promote its earlier development to maximise learning. The aim of this research was to explore the promotors and inhibiters of feedback-seeking behaviour in learners, and the effect of a formative workplace-based assessment tool on these feedback-seeking barriers. METHODOLOGY AND METHODS: This is a qualitative study using constructive grounded theory. Data were collected from single and group interviews with thirteen students and eleven clinicians, and free text responses to questionnaires. Interview data were transcribed and analysed using a constant comparative analysis approach to develop key themes, which reached data saturation. A formative workplace-based assessment tool was developed and the pilot cycles evaluated, on 750 students and over a thousand clinicians in 6 NHS trusts across Scotland. RESULTS: Analysis identified intrinsic, extrinsic and feedback factors influencing feedback-seeking. Intrinsic inhibitors included fear of patients, the clinical environment, lack of confidence and unhelpful previous experiences of seeking feedback. The predicted feedback sign influenced the decision to feedback-seek, depending on whether the student sought feedback to improve performance or for reassurance. Extrinsic inhibitors included perceived lack of approachability or availability of staff, high clinical workload and hostile reactions of staff when approached. As students became more senior, they were more likely to seek feedback because they developed confidence and strategies to approach staff, which overcame fear. A formative workplace-based assessment tool enabled feedback-seeking in junior students, who lacked confidence to overcome barriers, by empowering them to approach clinicians and helped recognise feedback-seeking attempts. However, other students felt it reduced autonomy, viewing it as a task they were forced to do with little benefit. These students had already developed successful strategies to seek feedback, or found approaching staff extremely stressful and anxiety-provoking. DISCUSSION AND CONCLUSION: Understanding what inhibits feedback-seeking helps educational organisations support students to develop the skills and motivation to feedback-seek earlier. We can also help break down barriers ourselves, for example we can describe how to approach clinicians, and reassure them that this is an expected behaviour. Increasing staff receptivity to students’ feedback-seeking, through training to improve confidence and recognition of feedback-seeking, will increase success.