Understanding students' feedback use in medical progress testing: A qualitative interview study

Medical Education, vol. 58, pp. 980–988

Abstract

BACKGROUND: Active engagement with feedback is crucial for feedback to be effective and improve students' learning and achievement. Medical students are provided feedback on their development in the progress test (PT), which has been implemented in various medical curricula, although its format, integration and feedback differ across institutions. Existing research on engagement with feedback in the context of PT is not sufficient to make a definitive judgement on what works and which barriers exist. Therefore, we conducted an interview study to explore students' feedback use in medical progress testing. METHODS: All Dutch medical students participate in a national, curriculum-independent PT four times a year. This mandatory test, composed of multiple-choice questions, provides students with written feedback on their scores. Furthermore, an answer key is available to review their answers. Semi-structured interviews were conducted with 21 preclinical and clinical medical students who participated in the PT. Template analysis was performed on the qualitative data using a priori themes based on previous research on feedback use. RESULTS: Template analysis revealed that students faced challenges in crucial internal psychological processes that impact feedback use, including 'awareness', 'cognizance', 'agency' and 'volition'. Factors such as stakes, available time, feedback timing and feedback presentation contributed to these difficulties, ultimately hindering feedback use. Notably, feedback engagement was higher during clinical rotations, and students were interested in the feedback when seeking insights into their performance level and career perspectives. CONCLUSION: Our study enhanced the understanding of students' feedback utilisation in medical progress testing by identifying key processes and factors that impact feedback use. By recognising and addressing barriers in feedback use, we can improve both student and teacher feedback literacy, thereby transforming the PT into a more valuable learning tool.

Authors 5

1. Elise V. van Wijk Aachen Center for Innovation in Medical Education Leiden University Medical Center Leiden The Netherlands Center for Innovation in Medical Education

   Leiden University Medical Center

   Affiliation as printed

   Center for Innovation in Medical Education Leiden University Medical Center Leiden The Netherlands

   Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands

2. Floris M. van Blankenstein Aachen Center for Innovation in Medical Education Leiden University Medical Center Leiden The Netherlands Center for Innovation in Medical Education

   Leiden University Medical Center

   Affiliation as printed

   Center for Innovation in Medical Education Leiden University Medical Center Leiden The Netherlands

   Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands

3. Roemer J. Janse Aachen Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands Department of Clinical Epidemiology

   Leiden University Medical Center

   Affiliation as printed

   Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands

   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

4. Eline A. Dubois Aachen Center for Innovation in Medical Education Leiden University Medical Center Leiden The Netherlands Center for Innovation in Medical Education

   Leiden University Medical Center

   Affiliation as printed

   Center for Innovation in Medical Education Leiden University Medical Center Leiden The Netherlands

   Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands

5. Alexandra M. J. Langers corresponding Aachen Center for Innovation in Medical Education Leiden University Medical Center Leiden The Netherlands Department of Gastroenterology and Hepatology Leiden University Medical Center Leiden The Netherlands Center for Innovation in Medical Education Department of Gastroenterology and Hepatology

   Leiden University Medical Center

   Affiliation as printed

   Center for Innovation in Medical Education Leiden University Medical Center Leiden The Netherlands

   Department of Gastroenterology and Hepatology Leiden University Medical Center Leiden The Netherlands

   Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands

   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands