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The Feedback Tango: An Integrative Review and Analysis of the Content of the Teacher-Learner Feedback Exchange
Robert Bing-You1, Kalli Varaklis, Victoria Hayes
1R. Bing-You is professor, Tufts University School of Medicine, Boston, Massachusetts, and vice president for medical education, Maine Medical Center, Portland, Maine. K. Varaklis is clinical associate professor, Tufts University School of Medicine, Boston, Massachusetts, and designated institutional official, Maine Medical Center, Portland, Maine. V. Hayes is clinical assistant professor, Tufts University School of Medicine, Boston, Massachusetts, and faculty member, Department of Family Medicine, Maine Medical Center, Portland, Maine. R. Trowbridge is associate professor, Tufts University School of Medicine, Boston, Massachusetts, and director of undergraduate medical education, Department of Medicine, Maine Medical Center, Portland, Maine. H. Kemp is medical librarian, Maine Medical Center, Portland, Maine. D. McKelvy is manager of library and knowledge services, Maine Medical Center, Portland, Maine.
Purpose:
To conduct an integrative review and analysis of the literature on the content of feedback to learners in medical education.
Method:
Following completion of a scoping review in 2016, the authors analyzed a subset of articles published through 2015 describing the analysis of feedback exchange content in various contexts: audiotapes, clinical examination, feedback cards, multisource feedback, videotapes, and written feedback. Two reviewers extracted data from these articles and identified common themes.
Results:
Of the 51 included articles, about half (49%) were published since 2011. Most involved medical students (43%) or residents (43%). A leniency bias was noted in many (37%), as there was frequently reluctance to provide constructive feedback. More than one-quarter (29%) indicated the feedback was low in quality (e.g., too general, limited amount, no action plans). Some (16%) indicated faculty dominated conversations, did not use feedback forms appropriately, or provided inadequate feedback, even after training. Multiple feedback tools were used, with some articles (14%) describing varying degrees of use, completion, or legibility. Some articles (14%) noted the impact of the gender of the feedback provider or learner.
Conclusions:
The findings reveal that the exchange of feedback is troubled by low-quality feedback, leniency bias, faculty deficient in feedback competencies, challenges with multiple feedback tools, and gender impacts. Using the tango dance form as a metaphor for this dynamic partnership, the authors recommend ways to improve feedback for teachers and learners willing to partner with each other and engage in the complexities of the feedback exchange.