Muirne Spooner¹
Teresa Pawlikowska¹
1 Royal College of Surgeons in Ireland University of Medicine and Health Sciences 

Research differs on how feedback-seeking behaviours (FSB) develop during training. Medical student migration and programme internationalisation. have implications for how Western- derived educational practices affect diverse learner populations (2). Exploring undergraduate activity using a validated model of FSB(1) may give insight into how FSB evolves and the influence of situational factors such as nationality and site of study. Our findings seek to inform medical school processes that support feedback literacy. 

Using a mixed methods approach, we collected questionnaire and interview data from final- yearmedicalstudentsinIreland,BahrainandMalaysia. Avalidatedquestionnaireinvestigated relationships with FSB and goal orientation, leadership style preference, and perceived costs and benefits. Interviews with the same student population explored their FSB experiences in clinical practice, qualitatively, enriching this data. Data were integrated using the “following the thread” technique 

Of 514 students, 325 completed questionnaires, 57 participated in interviews. Learning goal orientation (LGO), instrumental leadership and supportive leadership related positively to perceived feedback benefits. (0.23, 0.2 and 0.31, respectively, P<0.05). Perceived feedback benefits related positively to Feedback Monitoring and Inquiry (0.13 and 0.38, respectively, P<0.05). While unsupported in quantitative data, personal costs were a strong theme in interviews, as were feedback avoidance, peer feedback and unsupportive learning environment. There were no differences in sub-groups based on gender, study site or student nationality. Integrated analysis uncovered 3 themes: avoiding “unsafe” feedback (first, do no harm), overcoming barriers (beat the system) and goal-centred curation (shop around) in FSB. 

Diverse students at culturally distinct sites share FSBs. They carefully navigate feedback- seeking, as a valued but risky business, that is highly contextualised. 

Conclusion

Promoting constructive FSB is complex. Overcoming outdated theory and practices on the wards remains a challenge to psychologically safe, learner-centred feedback. Postgraduate models to support feedback need adapting for undergraduate contexts. 

References (maximum three) 

1. Teunissen, Pim W, Stapel, Diederik A, van der Vleuten, Cees, Scherpbier, Albert, Boor, Klarke, & Scheele, Fedde. (2009). Who wants feedback? An investigation of the variables influencing residents’ feedback-seeking behavior in relation to night shifts. Academic Medicine, 84(7), 910-917 

2. Brouwer, Emmaline, Driessen, Erik, Mamat, Norul Hidayah, Nadarajah, Vishna Devi, Somodi, Klara, & Frambach, Janneke. (2020). Educating universal professionals or global physicians? A multi-centre study of international medical programmes design. Medical Teacher, 42(2), 221-227.