Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes

被引:264
作者
Eva, Kevin W. [1 ]
Armson, Heather [2 ]
Holmboe, Eric [3 ]
Lockyer, Jocelyn [2 ]
Loney, Elaine [4 ]
Mann, Karen [4 ]
Sargeant, Joan [4 ]
机构
[1] Univ British Columbia, Ctr Hlth Educ Scholarship, Vancouver, BC V5Z 4E3, Canada
[2] Univ Calgary, Calgary, AB T2N 1N4, Canada
[3] Amer Board Internal Med, Philadelphia, PA 19106 USA
[4] Dalhousie Univ, Halifax, NS B3H 4R2, Canada
关键词
Self-appraisal; Feedback; Confidence; Self-assessment; Performance improvement; SELF-ASSESSMENT; JUDGMENT;
D O I
10.1007/s10459-011-9290-7
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
Self-appraisal has repeatedly been shown to be inadequate as a mechanism for performance improvement. This has placed greater emphasis on understanding the processes through which self-perception and external feedback interact to influence professional development. As feedback is inevitably interpreted through the lens of one's self-perceptions it is important to understand how learners interpret, accept, and use feedback (or not) and the factors that influence those interpretations. 134 participants from 8 health professional training/continuing competence programs were recruited to participate in focus groups. Analyses were designed to (a) elicit understandings of the processes used by learners and physicians to interpret, accept and use (or not) data to inform their perceptions of their clinical performance, and (b) further understand the factors (internal and external) believed to influence interpretation of feedback. Multiple influences appear to impact upon the interpretation and uptake of feedback. These include confidence, experience, and fear of not appearing knowledgeable. Importantly, however, each could have a paradoxical effect of both increasing and decreasing receptivity. Less prevalent but nonetheless important themes suggested mechanisms through which cognitive reasoning processes might impede growth from formative feedback. Many studies have examined the effectiveness of feedback through variable interventions focused on feedback delivery. This study suggests that it is equally important to consider feedback from the perspective of how it is received. The interplay observed between fear, confidence, and reasoning processes reinforces the notion that there is no simple recipe for the delivery of effective feedback. These factors should be taken into account when trying to understand (a) why self-appraisal can be flawed, (b) why appropriate external feedback is vital (yet can be ineffective), and (c) why we may need to disentangle the goals of performance improvement from the goals of improving self-assessment.
引用
收藏
页码:15 / 26
页数:12
相关论文
共 31 条
[1]  
[Anonymous], 1997, Self-efficacy: The exercise of control
[2]   Relationship-centered care - A constructive reframing [J].
Beach, MC ;
Inui, T .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2006, 21 (Suppl 1) :S3-S8
[3]  
Bjork RA, 1999, ATTENTION PERFORM, V17, P435
[4]   An investigation of medical student reactions to feedback: a randomised controlled trial [J].
Boehler, Margaret L. ;
Rogers, David A. ;
Schwind, Cathy J. ;
Mayforth, Ruth ;
Quin, Jacquelyn ;
Williams, Reed G. ;
Dunnington, Gary .
MEDICAL EDUCATION, 2006, 40 (08) :746-749
[5]  
Boud D., 1999, SOC WORK EDUC, V18, P121, DOI [DOI 10.1080/02615479911220131, 10.1080/02615479911220131]
[6]  
Davis D.A., 2006, Journal of the American Medical Association, V288, P1057
[7]  
Dunning David, 2004, Psychol Sci Public Interest, V5, P69, DOI 10.1111/j.1529-1006.2004.00018.x
[8]  
Dweck C.S., 1999, American Educator, V23, P4
[9]   Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains [J].
Ericsson, KA .
ACADEMIC MEDICINE, 2004, 79 (10) :S70-S81
[10]   I'll never play professional football and other fallacies of self-assessment [J].
Eva, Kevin W. ;
Regehr, Glenn .
JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, 2008, 28 (01) :14-19