Exploring feedback and feedforward in dental education using a followership model

The study aimed to explore the feedback and feedforward quality in the clinical setting and the usability of a followership model as a framework to analyze and map students' peer feedback.

Feedback and feedforward from 59 fourth-year dental students' clinical portfolios were collected and analyzed using a combination of deductive coding and interpretative content analysis. The analysis was first organized into predefined code categories (specific and actionable, non-specific, confirmatory, description of what was done, and other comments). The comments provided to peers were clustered and analyzed in relation to Kelley's theoretical followership framework.

A total of 3,877 free-text comments were included in the analysis. Regardless of role, most comments were coded as specific and actionable (n = 3,012). Confirmatory comments were frequently directed at peers. Comments that were only confirmatory were defined as reflecting dependent, uncritical thinking and passive behavior; this was the most frequent category among peer comments (n = 656). Non-specific comments were defined as reflecting dependent, uncritical thinking and active behavior, and this category was rare (n = 79). Comments that were confirmatory, specific, and actionable were defined as expressions of independent, critical thinking and active behavior (n = 442).

The analysis of feedback and feedforward in relation to followership seems to be a valid conceptual model. We found that peer feedback was often confirmatory and could be improved by incorporating specific and actionable feedforward. The followership model was shown to be a useful tool for structuring and analyzing peer feedback and feedforward, and it will be used as a tool for learning and quality assessment in future longitudinal studies.