Beyond the Grade: Exploring Written Feedback in a Pediatric Clerkship

Area of Science:

• Medical Education
• Military Medicine
• Qualitative Research

Background:

• Narrative feedback is crucial for developing clinical skills and professional identity in medical students.
• Existing research on feedback primarily focuses on civilian undergraduate medical education.
• The Uniformed Services University (USU) trains military service members, requiring integration of clinical skills with military medical standards.

Purpose of the Study:

• To examine themes and characteristics in written feedback for military medical students during their pediatric clerkship.
• To understand how feedback supports or hinders the development of military physicians within the Military Health System.

Main Methods:

• Qualitative, retrospective analysis of 953 written feedback comments.
• Feedback was collected from preceptors using an online survey tool.
• Comments were analyzed thematically and by summary content, focusing on Professionalism, Reporting, Interpreting, Managing, and Educating (PRIME) domains.

Main Results:

• Five key themes emerged: evaluating students as learners and emerging physicians, cultivating professional identity, praise/encouragement, and scope of evaluation.
• Performance comments were longer and more often in the third person; growth comments were shorter and often lacked a subject.
• Only 26.65% of comments explicitly utilized the PRIME schema.

Conclusions:

• Feedback partially aligns with best practices, focusing on observable behaviors and professional characteristics.
• Themes suggest an acculturation process to the military system and ethos alongside medical training.
• Prevalent use of less productive feedback (personal traits, general praise, depersonalized criticism) indicates a need for novel approaches, possibly involving artificial intelligence (AI).