Diantha Soemantri¹
Anyta Pinasthika¹ and Nadia Greviana¹
1 Department of Medical Education Faculty of Medicine Universitas Indonesia 

Verbal and written feedback are considered important to support learning. Nevertheless, less is understood about written feedback provision in medical education, which can be a burdensome task for teachers. Therefore, this study is conducted to examine the factors influencing the provision of written feedback, including cognitive and emotional aspects. 

Summary of work

This study used a descriptive qualitative design which involved 33 medical teachers, selected using maximum variety sampling, distributed into four focus groups (FGs). FGs were conducted using an interview guide developed based on thorough literature review focusing on written feedback delivery. Data was then transcribed verbatim and analyzed using thematic analysis. 

We identified four main components in providing written feedback consisting of teachers, students’ tasks or assignments, impact of feedback and system/educational environment, which affected delivery of written feedback through either cognitive or affective mechanism i.e: the quality of students’ assignment (cognitive) and the nature of the students-teachers relationship (affective) shaped teachers’ written feedback. The availability of role model affectively shaped teachers’ willingness to provide written feedback, whereas standardized rubric or system to facilitate written feedback is an example of cognitive domain which impacted on the teachers’ ability to provide written feedback. 

Providing written feedback is proven to be a complex process which may not only increase teachers’ cognitive load but can also be emotionally exhausting. Therefore, measures should be taken to support this important task of providing written feedback, including establishing adequate institutional policies and system, empowering students’ feedback seeking behavior, and improving teachers’ self-regulating ability. 

Supporting teachers’ roles in giving written feedback requires attention to a wide range of factors, from teachers self-regulating ability to the institutional policies. 

Providing written feedback is important. However, since it is a cognitive and emotion laden process, multifaceted supports are required. 

References (maximum three) 

Yu S, Zheng Y, Jiang L, Lu C, Xu Y. “I even feel annoyed and angry”: Teacher emotional experiences in giving feedback on student writing. Assessing Writing. 2021. 100528 

Bing-You R, Hayes V, Varaklis K, Trowbridge R, Kemp H, McKelvy D. Feedback for learners in medical education: What is known? A Scoping Review. Acad med. 2017. 92(9): 1346-54 

Rashmi Watson¹
1 The University of Western Australia 

Background:
The new Work-Based Assessment (WBA) tasks utilising the new Entrustable Professional Activity (EPA) format through the collaborative multi-institutional network ACCLAiM was piloted by the UWA, Medical School in 2023. Feedback forms an integral part of the learning process (Burgess et al., 2020) with multiple outcomes informing progress, motivating learning and highlighting key areas for improvement. 

Summary and results:
In this new format, assessors are required to provide feedback for learning to the final year students in preparation for their internship. Feedback provided by assessors ranged from comments/statements/affirmations/constructive feedback. 

The presentation will examine the types of feedback provided by assessors and lessons learnt (so far) in the journey of the implementation. 

References (maximum three) 

Burgess, A., van Diggele, C., Roberts, C., & Mellis, C. (2020). Feedback in the clinical setting. BMC Med Educ, 20(Suppl 2), 460. https://doi.org/10.1186/s12909-020-02280-5 [pii] 

2280 [pii] 10.1186/s12909-020-02280-5 [doi] 

Molloy, E., Boud, D., & Henderson, M. (2020). Developing a learning-centred framework for feedback literacy. Assessment & Evaluation in Higher Education, 45(4), 527-540. https://doi.org/10.1080/02602938.2019.1667955 

Ramani, S., & Krackov, S. K. (2012). Twelve tips for giving feedback effectively in the clinical environment. Medical Teacher, 34(10), 787-791. https://doi.org/10.3109/0142159x.2012.684916 

Neil Osheroff¹
Kimberly Dahlman² and Cathleen Pettepher¹
1 Vanderbilt University School of Medicine
2 Vanderbilt University Medical Center

Health professionals require skills and attitudes beyond medical knowledge. However, because of the heavy focus on medical knowledge during pre-clerkship training, programs often struggle to incorporate experiences and assessments that prepare students for all aspects of clinical work. One approach to addressing this important issue is to incorporate competency- based feedback schemes into the pre-clerkship curriculum. While maintaining the importance of medical knowledge, competency-based feedback strategies provide students with a roadmap that addresses all aspects of their performance and encourages learner development and professionalism. 

Competencies allow for the development of students with greater inquiry, more holistic thought processes, and enhanced maturity. 

The workshop will begin with an interactive discussion that will provide an understanding of competency-based feedback. It will explore the advantages and challenges of incorporating competency-based feedback into health professions curricula and the use of written and oral feedback. Attendees will break into small groups and with the assistance of facilitators, will devise approaches for integrating novel activities into their curricula that could be used to observe specific student behaviors and apply competency-based feedback. Participants will share their strategies in a report out session and return to their small groups to develop approaches for delivering oral and written feedback to trainees. The workshop will close with an interactive group discussion about how competency-based feedback can be leveraged to enhance student development and sustainability as well as the successes and challenges of providing feedback to early health professional trainees. 

This workshop will benefit curricular leaders, administrators, and faculty who are involved in health professional education and assessment. Although the workshop will focus on pre- clerkship learners, educators who teach in the clinical workplace will also benefit greatly. 

This workshop will benefit all levels of attendees. 

Intended Outcomes: 

Attendees will leave with an understanding of the advantages of competency-based written and oral learner feedback and with practical strategies for incorporating them into the pre-clerkship science curriculum at their institutions. The approach described in this workshop enhances curricular integration and encourages learners to shift their focus from course grades to their preparation for the profession. It also fosters habits of self-reflection and life-long learning. 

This workshop can accommodate any number of participants. 

C.C. Pettepher, K.D. Lomis, and N. Osheroff (2016) Med. Sci. Educ.26, 491-497. “From Theory to Practice: Utilizing Competency-based Milestones to Assess Professional Growth and Development in the Foundational Science Blocks of a Pre-Clerkship Medical School Curriculum.” 

E.C. Bird, N. Osheroff, C.C. Pettepher, W.B. Cutrer, andR.H. Carnahan (2017) Med. Sci. Educ.27, 759-765. “Using Small Case-Based Learning Groups as a Setting for Teaching Medical Students How to Provide and Receive Peer Feedback.” 

K.B. Dahlman, M.B. Weinger, K.D. Lomis, L.B. Nanney,N. Osheroff, D.E. Moore, L. Estrada, and W.B. Cutrer (2018) Med. Sci. Educ. 28, 145-154.“Integrating Foundational Sciences in a Meaningful Clinical Context in the Post-Clerkship Curriculum.” 

Kelsey Compagna¹
Shelley Ross¹ and Ann Lee¹
1 University of Alberta 

Background
Hattie and Timperley (2007) systematically investigated published research about feedback’s influence on learning. They found that the effectiveness of feedback to learning is determined by the type of feedback and the way that feedback is shared. Hattie and Timperley proposed a feedback model that included four major ‘levels’. Each level refers to the focus of feedback: Task, Process, Self-regulation, and Self. While many feedback researchers in health professions education (HPE) cite Hattie and Timperley, few authors have explored the actual levels of feedback in the HPE context. In this study, we used FieldNotes (brief documentation of feedback) to explore levels of feedback in our program. 

Summary of work
Our family medicine postgraduate program uses formative workplace-based assessments called FieldNotes. Each FieldNote includes a brief summary of the feedback conversation between teacher and learner. We coded feedback levels in de-identified FieldNotes. Frequency counts and descriptives were calculated for the four feedback levels. 

Results
Of the FieldNotes examined (N=2250), 422 (5%) were excluded (no feedback). For the remainder of the FieldNotes, 1105 (60%) included only one feedback level, 705 (38%) included two, 17 (1%) included three, and none included four. The majority of the feedback included Task (835; 46%), Process (248; 13%), or Process and Task (649; 35%). 

Discussion
Our findings indicate that feedback shared with learners predominantly focused on either Hattie and Timperley’s levels of Task, Process, or both. Only 1% of the FieldNotes included three 

levels of feedback. However, it is also possible that narrative summaries of feedback conversations do not capture all levels of feedback that occurred in the actual conversation. 

Conclusions
Our findings enhance our understanding of feedback in our program, and offer potential directions for improving feedback effectiveness. 

Take home message
Hattie and Timperley’s feedback model offers a novel way to examine feedback effectiveness in HPE. 

References (maximum three) 

1. Hattie, J., & Timperley, H. (2007). The power of feedback. Review of Educational Research, 77(1), 81–112. https://doi.org/10.3102/003465430298487 

2. Ross S, Lawrence K, Bethune C, van der Goes T, Pélissier-Simard L, Donoff M, Crichton T, Laughlin T, Dhillon K, Potter M, Schultz K. Development, implementation, and meta- evaluation of a national approach to programmatic assessment in family medicine residency training. Academic Medicine 2023; 98(2):188-198 DOI 10.1097/ACM.0000000000004750