Turning Chairs, Opening Minds: Redesigning Feedback in Medical Clerkships

Clinical clerkships are essential for Dutch medical students to gain practical experience, but the learning environment in these rotations is often suboptimal. Hierarchical structures and cultural resistance to feedback can discourage students from voicing their concerns, limiting opportunities for mutual growth. To address this, we developed the Feedback and Feedforward Conversations (FFCs), inspired by healthcare 'mirror meetings', to foster bidirectional feedback in a psychologically safe setting.

The FFCs consist of three phases: (1) Students share their experiences, while faculty listen silently with their backs turned; (2) students and faculty reflect separately, identifying key topics; and (3) a structured dialogue explores solutions and opportunities for improvement. Meetings were held quarterly in 2022 with small groups of students and faculty, facilitated in offsite, informal settings to ensure openness.

Reflections from post-meeting focus groups informed refinements, including structuring discussions around care delivery, collaboration and personal experiences. The evaluation highlighted the FFCs' strengths in fostering psychological safety, enhancing educational value and promoting meaningful relationships. Faculty found emotionally delivered feedback particularly impactful.

The FFCs highlight the value of authentic student-faculty dialogue, emphasizing reciprocal feedback as a catalyst for professional growth and system improvement. The FFC tool shows potential for improving educational environments and fostering a culture of continuous learning. Future research should explore FFCs' broader applicability and long-term impact on clinical training and healthcare quality.