Marcy Rosenbaum^1,2
Conor Gilligan^3,4 and Miriam Grotowski³
1 EACH: International Assocation for Communication in Healthcare 2 University of Iowa College of Medicine
3 University of Newcastle
4 EACH: International Association for Communication in Healthcare

Background:
Recentyearshaveseenaplethoraofliteratureemergerelatingtotheimportance of, and providing recommendations for, giving feedback to learners in medical education. Our recent Cochrane review1 reinforces the importance of specific, personalised feedback as the most important factor in improving medical students’ interpersonal communication skills. However, students are rarely directly observed in their communication with patients in clinical practice, and therefore rarely receive feedback on their communication skills. This represents a missed opportunity for valuable, formative assessment. 

Why is this topic important?: There is often a disconnect between the communication skills training (CST) delivered in classroom settings, and that modelled and reinforced in clinical settings, with clinical supervisors and students often emphasising clinical content over the communication process in interactions.2 Exploration of the gaps between the content of patient encounters and case presentations has shown that social history, patient perspective, and communication quality are not often conveyed in clinical case presentations, heightening the difficulty of any feedback focus on these areas3. 

While CST has become ubiquitous in health professional curricula, supervising clinicians and clinical educators may have had limited exposure to CST. While teaching and assessment of communication skills during clinical training is important in order to reinforce communication skills learned in formal courses and develop new skills, clinical supervisors can find this task challenging to accomplish. 

This workshop will explore workplace based clinical communication assessment and feedback opportunities which can be embedded as formative components of all clinical placement and clerkship experiences. 

Workshop format:
The workshop will use experiential learning approaches to role-model and provide opportunities for all participants to practice key skills. 

10 minutes – introductions and eliciting participants’ learning needs 

10 minutes – discussion of key communication skills and consultation elements which can form the basis of formative feedback, and discussion of simple feedback structures/approaches 

60 minutes – role play practice with communication observation and feedback approaches. 10 minutes – wrap-up and take-home messages 

Who should participate?:
Anyone with a role in clinical teaching or supervision or working with those involved in clinical education. 

Level of workshop:
Beginner to advanced 

Take home messages:
The main goal of this workshop will be to provide educators with approaches to maximise opportunities for delivering brief, focused and constructive feedback on learners’ communication skills in time-limited clinical placement settings. 

References (maximum three)
Gilligan C, Powell M, Lynagh MC, Ward BM, Lonsdale C, Harvey P, James EL, Rich D, Dewi SP, Nepal S, Cro' HA, Silverman J. Interventions for improving medical students' interpersonal communication in medical consultations. Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No.: CD012418. DOI: 10.1002/14651858.CD012418.pub2. 

Melanie Fentoullis¹
Judy Kell¹ and Megan Kalucy¹
1 UNSW 

Whilst the competencies assessed through most workplace-based assessments (WBAs) are similar, the assessors vary widely. This impacts on both the reliability and validity of these assessments [i]. Learners who employ effective feedback practices anticipate their learning needs and seek feedback from a range of assessors to provide different perspectives and breadth on their clinical practice [ii]. Near peers will understand their current learning needs, senior peers are performing at the level they aiming to achieve, practicing clinicians and other health professionals will understand the health system and context within which their practice is applied, and patient feedback will support a deeper understanding of the application of patient- centred care. Whilst we encourage this variation, exploring strategies that do not rely on the almost impossible task of standardised assessor training is essential. 

Drawing on the parallels between being learner-centred as an educator and delivering patient- centred care as a clinician, we looked to tools from clinical medicine and those employed by other health and non-health disciplines to facilitate their professional practice. Drawing on the COIN (Context, Observation, Impact, Next Steps) model utilised in the business sector [iii], we incorporated these elements into the mini-CEX WBA form. We further enhanced the COIN framework by including categories of Impact relevant to clinical practice to scaffold and therefore enhance the feedback that assessors provide, and for our learners to use, to effectively navigate feedback discussions for greatest impact. 

Workshop format
This will be an interactive and experiential workshop. 

We will present our framework drawing on the COIN model and other disciplinary tools we have encountered that may apply to observational assessments of clinical practice (workplace- based assessments such as the mini-CEX). 

In small groups, participants will consider these tools and draw on their own experiences to explore other tools, models, or frameworks within, and outside of, their own discipline’s clinical and/or professional practice that may be adapted to such assessments within their own context. 

Participants will then explore and develop strategies to adapt and refine these tools to ensure relevance to the feedback discussions of observational assessments of clinical and/ or professional practice within their own learning and teaching setting. 

Following this, a whole-group discussion will aim to summarise the key findings and potential next steps for education research and practice. 

Who should participate?
Anyone involved in designing opportunities to provide and evaluate feedback in assessments of clinical and/or professional practice in health professional programs, higher education and healthcare workplaces. 

Level of workshop
Intermediate to advanced 

Number of participants
Maximum 25 

Take-home messages/workshop outcomes
Participants will identify translatable aspects of tools, models and frameworks utilised in clinical practice and/or professional practice outside their own discipline. Participants will then consider, refine and adapt these tools, models and frameworks to apply to observational assessments of clinical and/or professional practice within their own context. This workshop will provide an opportunity to scaffold and therefore enhance the feedback that assessors provide, and for learners to use, to effectively navigate feedback discussions for greatest impact. 

References (maximum three) 

[i] Ponnamperuma, G. 'Workplace based assessment', in Kieran Walsh (ed.), Oxford Textbook of Medical Education, Oxford Textbook (Oxford, 2013; online edn, Oxford Academic, 1 Oct. 2013), https://doi.org/10.1093/med/9780199652679.003.0046, accessed 9 Aug. 2023. 

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

[iii] Carroll, A. The Feedback Imperative: How to Give Everyday Feedback to Speed Up Your Team's Success: River Grove Books (2014).