Third year medical students impersonalize and hedge when providing negative upward feedback to clinical faculty

Abstract

Medical students provide clinical teaching faculty with feedback on their skills as educators through anonymous surveys at the end of their clerkship rotation. Because faculty are in a position of power, students are hesitant to provide candid feedback. Our objective was to determine if medical students were willing to provide negative upward feedback to clinical faculty and describe how they conveyed their feedback. A qualitative analysis of third year medical students’ open-ended comments from evaluations of six clerkships was performed using politeness theory as a conceptual framework. Students were asked to describe how the clerkship enhanced their learning and how it could be improved. Midway through the academic year, instructions to provide full names of faculty/residents was added. Overall, there were significantly more comments on what worked well than suggestions for improvement regarding faculty/residents. Instructing students to name-names increased the rate of naming from 35% to 75% for what worked well and from 13% to 39% for suggestions for improvement. Hedging language was included in 61% of suggestions for improvement, but only 2% of what worked well. Students described the variability of their experience, used passive language and qualified negative experiences with positive ones. Medical students may use linguistic strategies, such as impersonalizing and hedging, to mitigate the impact of negative upward feedback. Working towards a culture that supports upward feedback would allow students to feel more comfortable providing candid comments about their experience.

Keywords:

• Feedback
• evaluation
• undergraduate

Disclosure statement

The authors have no declarations of interest to report. The authors alone are responsible for the content and writing of the article.

Glossary

Upward Feedback: Subordinates rating the performance of their immediate supervisor.

(Smither, J. W., London, M., Vasilopoulos, N. L., Reilly, R. R., Millsap, R. E., & Salvemini, N. (1995). An examination of the effects of an upward feedback program over time. Personnel Psychology, 48(1), 1–34)

Additional information

Notes on contributors

Doreen M. Olvet

Doreen M. Olvet, PhD is Assistant Professor of Science Education and Medical Education Project Manager Department of Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.

Joanne M. Willey

Joanne M. Willey, PhD is the Leo A. Guthart Professor of Biomedical Sciences and Chair of the Department of Science Education at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.

Jeffrey B. Bird

Jeffrey B. Bird, MA is the Educational Research & Strategic Assessment Analyst and an Assistant Professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.

Jill M. Rabin

Jill M. Rabin, MD is Vice Chairperson of Obstetrics & Gynecology, LIJ/Northshore University Hospital/Northwell Health and Professor of Obstetrics & Gynecology at the Donald and Barbara School of Medicine at Hofstra/Northwell, Hempstead, NY.

R. Ellen Pearlman

R. Ellen Pearlman, MD, FACH is an Associate Professor of Medicine and Science Education and the Associate Dean for Professionalism and Doctoring Skills at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.

Judith Brenner

Judith Brenner, MD is an Associate Professor of Medicine and the Associate Dean for Educational Data and Analytics at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.