Investigating feedback orientation in medical learners

Abstract

Background/purpose

Feedback processes in health professions education (HPE) are not always successful. While recommendations to improve feedback provision dominate the literature, studying specific learner attributes that impact feedback uptake may also improve feedback processes. Feedback orientation is a concept from management science involving four dimensions of learner attributes and attitudes that impact their feedback uptake: utility, accountability, social awareness, and feedback self-efficacy. Feedback orientation may represent a valuable concept in HPE. We aimed to understand medical learners’ feedback orientation at different stages in their development.

Methods

We used the Feedback Orientation Scale, a 20-item survey instrument, for a cross-sectional analysis of feedback orientation in medical students and Internal Medicine residents at one large academic center. We performed descriptive statistics and analysis of variance for data analysis.

Results

We found the same factors (dimensions) to feedback orientation in our population as in management science. Overall feedback orientation scores were high and were largely consistent across trainee levels. Utility was the domain that was highest across learners, whereas feedback self-efficacy was lowest.

Conclusions

Feedback orientation represents a useful concept to explore medical learners’ attitudes toward feedback’s role in their development. The four domains can help guide further nuanced feedback research and application.

Practice points

• Feedback orientation is a concept from the management science literature that describes an individual’s feedback receptivity in a more durable way; it comprises 4 distinct domains: utility, accountability, social awareness, and feedback self-efficacy.

• The feedback orientation construct translates well to HPE.

• Medical learners’ overall feedback orientation is largely stable across training from early medical school to late residency.

• Medical learners’ highest scores are in the utility domain, whereas lowest are in feedback self-efficacy.

• Focusing on the individual domains of feedback orientation can help guide future, more nuanced research and interventions on feedback.

Keywords:

• Feedback
• feedback receptivity
• attitudes

Disclosure statement

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

Glossary

Feedback orientation: Is a construct described initially by London and Smither (2002) in the management science literature. It comprises multiple dimensions that work together to characterize an individual’s overall receptivity to feedback. Feedback orientation includes six domains: the individual’s general affect toward feedback (liking or disliking it, not being apprehensive); behavioral propensity to seek feedback; cognitive propensity to process feedback thoughtfully; awareness of others’ perceptions of oneself; belief in feedback’s value; and a sense of responsibility to act on feedback (London and Smither 2002). In each domain, learners can be higher or lower, and the domains can be combined to give an overall feedback orientation, again on a bipolar scale. Thus, higher overall feedback orientation relates to higher feedback receptivity. The concept was designed to describe individuals’ general feedback receptivity, not just their receptivity in a given situation (London and Smither 2002). Feedback orientation therefore provides a framework for thinking about individual learner characteristics that they consistently bring to the feedback setting which may influence their propensity for feedback uptake.

Additional information

Notes on contributors

Lynnea M. Mills

Lynnea M. Mills, MD, is Associate Professor in the Department of Medicine in the School of Medicine at University of California, San Francisco.

Patricia S. O’Sullivan

Patricia S. O’Sullivan, EdD, is Professor in the Department of Medicine and Department of Surgery, and Director of Research and Development in Medical Education in the Center for Faculty Educators at the University of California, San Francisco.

Olle ten Cate

Olle ten Cate, PhD, is Professor of medical education and senior scientist at the Center for Research and Development of Education at University Medical Center Utrecht, The Netherlands.

Christy Boscardin

Christy Boscardin, PhD, is Professor in the Department of Medicine and Department of Anesthesia and Perioperative Care in the School of Medicine at University of California, San Francisco.