Peer feedback as an aid to learning – What do we want? Feedback. When do we want it? Now!

Figures & data

Table

Practice points

The perceived novice status of peers may be addressed by the OSCE marking criteria for skills acquisition and development in giving feedback. Comparing students’ marking scheme with the pre-prepared mark sheets of faculty facilitated feedback being linked to shared goals. Training in feedback with directives providing areas for improvement is advised owing the dynamics of submitting performance to peer scrutiny.

Table 1.  Example of Feedback Sheet

		Well done	Adequate	To improve
	Introduction
1	Uses full name and role. Checks/asks patients name, preferred form of address
2	Explains purpose of interview and checks agreement including any note taking
3	Explains clearly confidentiality (as part of team who will see notes/hear findings)
	Rapport
4	Appropriate body language throughout
5	Non-judgmental (words, tone, manner, etc.)
	Exploration
6	Commences with open questions to explore the problem and encourages patient to tell his story
7	Questioning style: Balance of open and closed, no leading questions
8	Listens carefully and picks up on any cues
9	Clear questions and voice (volume and pace)
	Responding
10	Empathic (accurately reflects back the patient's feelings and concerns)
11	Avoids giving advice about treatment and encourages patient to ask doctor/offers to raise concerns with doctor
12	Handles confidentiality appropriately
	Closure
13	Appropriate closure
	Content
14	Gains a good understanding of Mr Desai's history
15	Gains good understanding of his medication ideas and concerns

Scenario: Bipolar disorder Candidate instructions: You are seeing Mr Nitesh Desai, aged 36, who has come for a regular review appointment. Diagnosed with bipolar disorder 10 years ago, he has since had two severe episodes of depression and on both occasions was admitted to hospital. The most recent admission was 3 months ago when he felt suicidal. He returned to work 1 month ago as an administrator in an import/export company. Task: Please ask Mr Desai about his recent episode and assess how he is feeling now.

Table 2.  Responses to positive statements of the questionnaire

	November OSCE	May OSCE
Questions Positive statements	Mean ± SD (% of cohort who agreed/strongly agreed)	Mean ± SD (% of cohort who agreed/strongly agreed)
Being the examiner was helpful in providing clear instructions on what was expected of me	3.49 ± 0.60 (95%)	3.35 ± 0.64 (96%)
With this exercise, there was lots of feedback	3.39 ± 0.57 (86%)	3.29 ± 0.65 (90%)
The feedback was rapid and helpful	3.21 ± 0.52 (82%)	3.08 ± 0.54 (90%)
Feedback helps me to understand issues better	3.30 ± 0.61 (95%)	3.21 ± 0.50 (95%)
Feedback helps me to improve	3.55 ± 0.55 (97%)	3.48 ± 0.55 (98%)
Receiving feedback helps me to understand why I got the mark I did	3.23 ± 0.64 (91%)	3.29 ± 0.62 (96%)
I found it difficult giving feedback to my colleagues	2.13 ± 0.61 (27%)	2.42 ± 0.71 (38%)
I found the feedback from the simulated patient helpful	3.60 ± 0.67 (95%)	3.40 ± 0.67 (90%)
I listen carefully to feedback	3.58 ± 0.50 (100%)	3.48 ± 0.50 (100%)
I will use the feedback to go over my performance	3.48 ± 0.60 (94%)	3.06 ± 0.70 (83%)
Feedback stimulates me to go back over material covered on other areas of the course	3.04 ± 0.71 (82%)	2.85 ± 0.62 (77%)
I learnt new things whilst being an examiner	3.12 ± 0.58 (91%)	3.23 ± 0.56 (92%)
I felt that I was able to be honest in my feedback	3.22 ± 0.60 (94%)	3.21 ± 0.54 (94%)
I would learn better if I had more in-depth feedback*	2.56 ± 0.85 (44%)	2.77 ± 0.75 (67%)

Notes: Likert Scale from which the mean data were derived: [1 Strongly disagree; 2 Disagree, 3 Agree, 4 Strongly agree].

*Response to the statement: ‘I would learn better if I had more in-depth feedback’ was statistically significant (p < 0.05).

Table 3.  Responses to negative statements of the questionnaire

	November OSCE	May OSCE
Questions Negative statements	Mean ± SD (% of cohort who disagreed/strongly disagreed)	Mean ± SD (% of cohort who disagreed/strongly disagreed)
When I got things wrong or misunderstood, I did not receive much guidance	−3.16 ± 0.59 (92%)	−3.02 ± 0.60 (88%)
The feedback I received was not useful	−3.48 ± 0.68 (92%)	−3.44 ± 0.45 (100%)
Feedback mainly tells me how well I did compared to others	−3.01 ± 0.83 (77%)	−3.10 ± 0.69 (85%)
I did not understand some of the feedback	−3.22 ± 0.67 (89%)	−3.08 ± 0.61 (88%)
I would prefer feedback from tutors rather than my colleagues**	−3.17 ± 0.66 (84%)	−2.35 ± 0.81 (52%)
Feedback is not likely to be much help for the future performances	−3.39 ± 0.69 (90%)	−3.46 ± 0.54 (98%)

Notes: Likert Scale from which the statistical data were derived. [−1 Strongly agree; −2 Agree, −3 Disagree, −4 Strongly disagree]. **Response to the statement: ‘I would prefer feedback from tutors rather than my colleagues’ was statistically significant (p < 0.01).

Table 4.  Results of the focus group following Study 1

Most helpful to learning	• Seeing both good and bad communications
	• How different people deal with the same situation
	• Knowing what to look for in others helps you understand what you should do yourself
Less helpful to learning	• Marking criteria was too long
	• Peers are ‘amateurs’, both at the skills being role-played and at feedback
	• Some people are not brave enough in giving critical feedback
Suggested improvements	• An introductory session on how to give constructive criticism
	• Be told to give feedback on how to improve performance
	• Prior knowledge of the OSCE stations
	• Allow more time for feedback (both the giving and to assimilate of feedback)