What are students' needs and preferences for academic feedback in higher education? A systematic review

Exploring Feedback Mechanics during Experiential Learning in Pharmacy Education: A Scoping Review

(1) Background: This scoping review aims to explore the literature on feedback for pharmacy students during experiential learning, with a focus on identifying the modes of delivery of feedback and the perceived impact of feedback on student learning outcomes. (2) Methods: The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR) guidelines. PubMed, Web of Science, Embase, EBSCO, ERIC, and ProQuest Central were searched electronically from their inception until the end of February 2023 using a combination of keywords and MeSH terms related to feedback, pharmacy education, and student learning outcomes. Data were synthesized narratively. (3) Results: This review included 13 studies published between 2008 and 2022. Almost half of the included studies were conducted in the USA (n = 6, 46%) and reported the perspective of undergraduate pharmacy students (n = 6, 46%). Verbal feedback was the most common mode of feedback delivery (n = 6, 46%). The enablers of effective feedback included timely feedback (n = 6, 46%), feedback provided in a goal-oriented and objective manner (n = 5, 40%), and student-specific feedback (n = 4, 30%). On the other hand, the most common impediments to feedback efficacy were providing extremely positive feedback and lack of constructive criticism. (4) Conclusions: Our findings highlight the importance of feedback model implementation in pharmacy education and preceptor training programs to ensure effective and quality feedback to pharmacy students.

Group Assessments to Help Build Online Learning Communities in Biomedical Science Distance Learning Programmes

Introduction: Biomedical Science distance learning courses offer flexibility in study while in employment. Asynchronous and self-learning approaches are common within such courses and often student-student interaction is limited. The aims of this study were to establish learning communities, develop confidence in participating in online teamwork and foster an appreciation of transferable skills including digital capabilities through remote group activities. Materials and Methods: Two cohorts of students (n = 20/n = 21) were enrolled in a microbiology module of an IBMS accredited MSc distance learning course. Groups of 4-5 students produced a digital output relating to current global infection-related issues, namely, assignment 1, production of a slide deck, which peers could use as learning resources and assignment 2, a voiceover PowerPoint debate, and infographic, voting assessment and peer/self-marking. Students also prepared reflections using written format and a FlipGrid video-recording. A qualitative content analysis was conducted on reflections from all students. Students completed a pre- and post-assignment survey focused on the development of transferable skills for the biomedical sector. Results: Students' skills and confidence increased following completion of the group assignment, as evident from the pre- and post-questionnaire responses, namely, possession of digital skills and digital creation abilities (29% v 83%), applying for jobs which require digital skills (54% v 89%), talking about examples of using digital media during job interviews (21% v 78%) and demonstration of creativity during assignment tasks (33% v 90%). Critical thinking was more commonly demonstrated during the debate in comparison to the slide deck activity (p = 0.001). The importance of developing digital skills, was higher following completion of the group activities (p = 0.03). Students reflected on the value of the group activities in relation to knowledge acquisition (85%, 86%), collegiality (70%, 71%), digital skills development (80%, 90%), the fact that the activities were enjoyable (70%, 67%) and the development of peer interaction and support (50%, 67%) in relation to assignment 1 and 2, respectively. Discussion: Increasingly digital technologies are being used in the healthcare sector resulting in updated HCPC Standards of Proficiency. This study highlights that virtual group activities promote the establishment of supportive learning communities and the development of transferable skills including digital capabilities for application within the biomedical science workplace.

Developing student nurses' evaluative judgement in clinical practice tertiary education: A systematic scoping review of teaching and assessment methods

OBJECTIVES

This review aimed to systematically scope undergraduate or postgraduate tertiary higher education nursing students' clinical practice teaching and assessment methods to identify features that align with promoting students' evaluative judgement.

INTRODUCTION

Evaluative judgement is a new concept to nursing tertiary education. Currently, there are no published reviews of evaluative judgement in nursing clinical practice education. This review aims to assist nursing educators to operationalise the concept of evaluative judgement in clinical practice education. As such the starting point was to determine features of evaluative judgement in current clinical teaching and assessment designs.

INCLUSION CRITERIA

Peer reviewed qualitative or quantitative studies that have evaluated teaching and/or assessment of tertiary (university/higher education) pre-registration (undergraduate) or post-registration (postgraduate) nursing students' clinical practice.

METHODS

The systematic scoping review was prospectively registered systematic review (OSF DOI 10.17605/OSF.IO/PYWZ6) reported using PRISMA guidelines. A systematic search of five databases (Medline, Scopus, Web of Science, ProQuest, CINAHL) was conducted, limited from 1989 onwards and in English. Two reviewers independently screened titles and abstracts, then full text, with disagreements resolved with a third independent author. Data were extracted, including the frequency and methods of developing students' evaluative judgement across the categories of discerning quality, judgement process, calibration and feedback. A narrative synthesis was performed.

RESULTS

Seventy-one studies were included (n=53 teaching, n=18 assessment). Most of the included studies, included some, but not all, of the features to develop nursing students' evaluative judgment. For teaching methods, the most identified evaluative judgement features in the included studies were discerning quality (n=47), feedback (n=41) and judgement process (n=21). Only three studies included a method of calibration. For the assessment methods, feedback (n=16), discerning quality (n=15), judgement process (n=9) and calibration (n=4) were included. Many clinical practice teaching and assessment methods in nursing included features that develop students' evaluative judgement, with methods relating to discerning quality and feedback well embedded. Further adjustments are required to include methods to assist students to judge and calibrate their own performance.

CONCLUSION

This systematic scoping review identified that evaluative judgement in current nursing clinical teaching and assessment is not an overt aim. With minor adjustment to teaching and assessment design, nursing students could be better supported to develop their ability to judge the value of their own work.

Dispersed assessment: A novel approach to enhancing student engagement during and beyond Covid-19

The Covid-19 pandemic and the subsequent need to shift between face-to-face, online, and blended learning caused considerable disruption to student engagement and the workload of academics. Drawing on a Brand Management course (final year undergraduate) in a UK university, this study discusses the students' perception of, and reflection on, a novel method of assessment that we have termed dispersed assessment. This is defined as multiple credit-bearing tasks that are spread throughout the teaching period, are related to taught learning materials and sessions, assist in completing a related final assessment task, and are evidenced in the submission of the final task to limit additional burden on students and markers. Based on scholarly work on assessment and student engagement, we used Leximancer-assisted thematic analysis to examine the data from three focus groups and students’ written reflections (n = 99). Findings show that dispersed assessment significantly enhanced student engagement, without overburdening students or increasing the marking workload. This novel method of assessment helped nurture learning communities, increase motivation, and reduce procrastination. Regarding policy, we recommend the implementation of dispersed assessment to encourage active and continuous student engagement and improve student experience. Practical examples are offered for the implementation of dispersed assessment using VLE technologies.

Analysis of Expert Feedback to Determine Intellectual Standards for Student Pharmacist Clinical Reasoning Development

Objectives. Clinical reasoning (CR) is one of the most important skills for pharmacy learners. Feedback has been proposed as a pedagogy to improve CR skills; however, essential components of CR have yet to be determined within pharmacy education. This study sought to streamline feedback to align with the Pharmacists' Patient Care Process (PPCP).Methods. The investigators used deidentified clinical reasoning "Keep," "Start," or "Stop" (KSS) feedback comments from student-written CR "think-aloud" sessions with pharmacy students in their third professional year. Sections were mapped to the PPCP and were coded by 2 independent investigators according to proposed essential components of CR, using an adapted grounded-theory approach. Investigators could inductively add codes after conferring with the other. Coded feedback was analyzed using a summative content approach. Intercoder reliability was calculated via Holsti index.Results. Five essential components of CR were identified after analysis of 635 KSS comments. The 5 essential components of CR were coded 1178 times. "Accurate," "Concise," "Specific," and "Thorough" were identified a priori, while "Connected" was discovered during feedback comment review. Literature analysis added supporting data to these results through the Paul-Elder Critical Thinking Framework. To maintain consistency in language, these essential components will be referred to as "intellectual standards" moving forward.Conclusion. This novel study successfully identified 5 key intellectual standards of CR. These intellectual standards provide a framework for pharmacy educators to focus feedback to improve student CR. Future research of other intellectual standards pertinent to experiential education is imperative.

Using peer feedback to enhance nursing students’ reflective abilities, clinical competencies, and sense of empowerment: a mixed-methods study

AIM

To assess the use of a framework to provide structured peer feedback and compare the effects of peer video feedback, peer verbal feedback versus faculty feedback on nursing students and peer tutors' learning outcomes and experiences BACKGROUND: Peer feedback has been utilized widely in health professions education to fill the gap for timely feedback, but some students were concerned with its quality, leading to perceptions that peer feedback may not be useful.

DESIGN

Sequential explanatory mixed-methods study METHODS: The study took place from January to February 2022. In phase 1, a quasi-experimental pretest-posttest design was used. First-year nursing students (n = 164) were allocated to peer video feedback, peer verbal feedback or faculty feedback arms. Senior nursing students (n = 69) were recruited to be peer tutors or the control group. The Groningen Reflective Ability Scale was used by first-year students to assess their reflective abilities, while the Simulation-based Assessment Tool was used by peer or faculty tutors to evaluate nursing students' clinical competence of a nursing skill during the simulation. The Debriefing Assessment for Simulation in Healthcare-Student Version was used by students to assess their peer/faculty tutors' feedback quality. Senior students' empowerment levels were measured using the Qualities of an Empowered Nurse scale. In phase 2, six semi-structured focus group discussions with peer tutors (n = 29) were conducted and thematically analyzed.

RESULTS

Peer video feedback and peer verbal feedback significantly improved students' reflective abilities but not in the faculty feedback arm. Students' clinical competence in a technical nursing skill significantly improved in all three arms. Improvements were significantly larger in those receiving peer video feedback and peer verbal feedback than faculty feedback, with no significant differences between peer video feedback and peer verbal feedback. Debriefing Assessment for Simulation in Healthcare-Student Version scores were not significantly different among the 3 arms. Empowerment levels of peer tutors significantly improved after providing peer feedback but not those in the control group. Seven themes were generated from the focus group discussions.

CONCLUSIONS

Although peer video feedback and peer verbal feedback were similarly effective in improving clinical competencies, peer video feedback was more time-consuming and stressful to students. The use of structured peer feedback improved peer tutors' feedback practices and were comparable to quality of faculty feedback. It also significantly increased their sense of empowerment. Peer feedback was widely supported by peer tutors who agreed that it should supplement faculty teaching.

A learning community within nursing practice: The value created by the activities and interactions during the early stage of community development

AIM/OBJECTIVE

This study examines the value that learning community activities and interactions produce (immediate value) during the early stage of community development, contributing to scientific insights on value creation.

BACKGROUND

Due to the rapidly changing healthcare landscape, nurses and nursing students need to adjust their skills, knowledge and collaboration with colleagues and other disciplines. Learning communities are a promising approach to enhancing professional growth and collaboration, where members find value through participation in the community.

DESIGN

For the study, a qualitative design was used.

METHODS

A secondary analysis of case study data, collected during the first five sessions of a hospital learning community comprised of nurses, nursing students and a nurse lecturer, was conducted.

RESULTS

The analysis revealed immediate value related to five themes: participation, activity, engagement, interaction, and confidence/trust. Members were encouraged to participate in and be involved during activities and interactions, such as asking questions, sharing their experiences and receiving feedback. Members became more familiar and confident in later community sessions, promoting immediate value creation. This was indicated by the different members who became active, took initiative or discussed problems.

CONCLUSIONS

It is concluded that the activities and interactions produce value during the early stage of community development but may also grow to include new activities and interactions associated with further community development.

Teacher Education during the COVID-19 Lockdown: Insights from a Formative Intervention Approach Involving Online Feedback

This paper examines preservice teachers’ perspectives on assessment feedback developed in a teacher education course during the first lockdown due to the COVID-19 pandemic. As initially negotiated with students, feedback was learner-centred and involved a formative intervention approach applied iteratively by the teacher educator over the course of one semester. Although such feedback was initially face-to-face, it had to be given exclusively online following the unexpected closure of the university. Analysis of student teachers’ perspectives, which were collected through an online questionnaire completed after their final assessment, reveals both positive and critical aspects regarding the feedback provided by the teacher educator. While reaffirming the significance of feedback as a crucial element for learning in online teacher education contexts, the findings also show that the clarity, affective bonding and multimodal meaning-making involved in face-to-face interaction are particularly challenging when the communication of feedback is digitally mediated. The implications and limitations of such findings are discussed.

Feedback for Learning in Pharmacy Education: A Scoping Review

Feedback is an effective pedagogy aimed to create cognitive dissonance and reinforce learning as a key component of clinical training programs. Pharmacy learners receive constant feedback. However, there is limited understanding of how feedback is utilized in pharmacy education. This scoping review sought to summarize the breadth and depth of the use of feedback within pharmacy education and identify areas for future research. PubMed, Embase, Scopus, and Web of Science were searched for English articles since January 2000 to identify studies related to feedback in pharmacy education. Sixty-four articles were included for analysis, stratified by moderate and major theory talk, where moderate theory talk explicitly included feedback into study design and major theory talk included feedback into both study design and analysis. Feedback was provided in Bachelor (14%), Master (15.6%), Doctor of Pharmacy (67.2%) and post-graduate programs (4.7%) on a variety of curricular objectives including communication and patient work up in didactic, objective structured clinical examination (OSCE), and experiential settings, and career/interview preparation in the co-curriculum. Feedback comments were mostly written in didactic courses, and both written and verbal in OSCE, experiential, and co-curricular settings. The pharmacy education feedback literature lacks depth beyond student perceptions, especially with respect to assessing the effectiveness and quality of feedback for learning. While feedback has been utilized throughout pharmacy education across myriad outcomes, several areas for inquiry exist which can inform the design of faculty and preceptor development programs, ensuring provision of effective, quality feedback to pharmacy learners.

Feedback Credibility in Healthcare Education: a Systematic Review and Synthesis

PURPOSE

The purpose of this study was to systematically review and synthesize factors that influence learners' perceptions of credibility when feedback is provided by an authority figure in a healthcare environment.

METHODS

This study reviewed literature from medicine, psychology, and education using systematic review and qualitative synthesis methods. In a multi-step process, major electronic bibliographic databases were searched for relevant studies until October 2020.

RESULTS

The search identified 9216 articles. A total of 134 abstracts underwent full-text review. Of these, 22 articles met inclusion criteria. The studies were heterogenous and the majority utilized a qualitative design with interviews and focus groups. A few studies employed mixed methodology (n = 2) and two studies used a quantitative design. Four main themes were identified: feedback characteristics, context of feedback, source credibility, and recipient characteristics.

CONCLUSION

As programs implement major educational change initiatives to create more formative assessment practices, feedback will become even more crucial. The four main themes identified are important factors that contribute to the perception of feedback credibility. While the factors are described independently, they may be viewed as interrelated and the association between these factors and feedback may be driven more by learning culture than each characteristic.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-020-01167-w.

The influence of a serious game's narrative on students' attitudes and learning experiences regarding delirium: an interview study

BACKGROUND

Delirium is a neuropsychiatric syndrome that affects patients' attention and awareness as a result of a physical condition. In recent years, persistent gaps in delirium education have led to suboptimal delirium care. Still, little is known about what are the most important aspects of effective delirium education. Serious games are both entertainment and an interactive, safe learning environment where players can experiment and create new knowledge. They have the potential to contribute to improved delirium education. We used a video-based serious games' narrative to explore aspects essential to enhance students' attitudes and learning experiences regarding delirium.

METHODS

We created a semi-structured interview guide and interviewed seven nursing and nine medical students about their attitudes and learning experiences, after they had played the game. A qualitative descriptive design and inductive content analysis with constant comparison were used.

RESULTS

The patient's and nurse's perspective, interactivity to experiment, realistic views on care options, and feedback on care actions were important for enhancing students' attitudes and learning experiences regarding delirium. Students felt these aspects encouraged them to get actively involved in and experiment with the study material, which in turn led to enhanced reflection on delirium care and education. Our findings highlight the importance of a more patient-oriented focus to delirium education to drive attitudinal change. Students' learning experiences were further enhanced through their affective responses provoked by the perspectives, interactivity, realism, and feedback.

CONCLUSIONS

Students considered the characters' perspectives, interactivity, realism, and feedback important aspects of the game to enhance their attitudes towards delirious patients and enrich their learning experiences. A patient-oriented narrative provides a clinically relevant experience in which reflection plays an important role. The serious game also serves as medium to actively experiment with care solutions to create better understanding of how healthcare professionals can influence a delirious patient's experience.