Premium
Feedback in action within bedside teaching encounters: a video ethnographic study
Author(s) -
Rizan Chantelle,
Elsey Christopher,
Lemon Thomas,
Grant Andrew,
Monrouxe Lynn V
Publication year - 2014
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/medu.12498
Subject(s) - context (archaeology) , conversation analysis , psychology , conversation , action (physics) , ambiguity , comprehension , qualitative research , action research , medical education , pedagogy , computer science , communication , medicine , sociology , paleontology , social science , physics , quantum mechanics , biology , programming language
Context Feedback associated with teaching activities is often synonymous with reflection on action, which comprises the evaluative assessment of performance out of its original context. Feedback in action (as correction during clinical encounters) is an underexplored, complementary resource facilitating students' understanding and learning. Objectives The purpose of this study was to explore the interactional patterns and correction modalities utilised in feedback sequences between doctors and students within general practice‐based bedside teaching encounters ( BTE s). Methods A qualitative video ethnographic approach was used. Participants were recorded in their natural settings to allow interactional practices to be contextually explored. We examined 12 BTE s recorded across four general practices and involving 12 patients, four general practitioners and four medical students (209 minutes and 20 seconds of data) taken from a larger corpus. Data analysis was facilitated by T ransana video analysis software and informed by previous conversation analysis research in ordinary conversation, classrooms and health care settings. Results A range of correction strategies across a spectrum of underlying explicitness were identified. Correction strategies classified at extreme poles of this scale (high or low explicitness) were believed to be less interactionally effective. For example, those using abrupt closing of topics (high explicitness) or interactional ambiguity (low explicitness) were thought to be less effective than embedded correction strategies that enabled the student to reach the correct answer with support. Conclusions We believe that educators who are explicitly taught linguistic strategies for how to manage feedback in BTE s might manage learning more effectively. For example, clinicians might maximise learning moments during BTE s by avoiding abrupt or ambiguous feedback practices. Embedded correction strategies can enhance student participation by guiding students towards the correct answer. Clinician corrections can sensitively manage student face‐saving by minimising the exposure of student error to patients. Furthermore, we believe that the effective practices highlighted by our analysis might facilitate successful transformation of feedback in action into feedback for action.