Supporting Feedback and Trust in CBME: A Conjoint WBA Workshop for Trainers and Trainees

Trainer disengagement, learner passivity and relational mistrust hinder effective workplace-based assessment (WBA) in postgraduate medical education. This study evaluated the impact of two conjoint WBA workshops on trainees' feedback literacy, trainers' motivation to engage in WBA and relational trust.

Mixed-methods study engaged 26 trainees and 16 trainers. Quantitative data were collected via pre-post surveys (81% trainee and 75% trainer response rates) using Feedback Literacy Behaviour Scale, Continuing Professional Development Reaction Questionnaire and Workplace-Based Assessment Trust Inventory. Six post-workshop focus groups (24/26 trainees in 4 groups; 11/16 trainers in 2 groups) were thematically analysed. Quantitative and qualitative findings were integrated through side-by-side interpretation.

Trainees demonstrated significant improvement in 'Provide Feedback' (p = 0.04) and 'Manage Affect' (p = 0.01). Trust showed no overall change, though perceptions of trainer ability improved (p = 0.047), reflecting the gradual nature of trust and limits of a brief intervention. Trainers reported higher moral norm (p = 0.04) and belief in positive consequences (p < 0.01). Qualitative findings showed participants reframed WBA as a learning dialogue, valued structured and emotionally safe practice and recognised the need for psychological safety and relational continuity. Yet hierarchical norms, unfamiliar pairings and brief duration constrained trust building.

Conjoint WBA workshop enhanced feedback literacy and trainer motivation. Although trust gains were constrained by hierarchical culture and short duration, the shared learning model shows promise as a faculty development strategy for trust building. Future iterations should embed conjoint learning longitudinally and incorporate culturally sensitive design to strengthen relational outcomes.