Exploring the Holistic Process of How Students Use Feedback in Clinical Clerkship

Abstract

Effective feedback can only be achieved when students act to improve their performance based on the feedback. This becomes even more important in clinical learning as students face authentic and relevant experiences to shape them as medical doctors. However, students do not always use feedback, even with efforts to improve feedback provided by teachers. Hence, understanding how they use feedback is a step toward achieving effective feedback. This study aimed to explore the process of how students in undergraduate clinical settings use feedback. This qualitative phenomenology study involved medical students on their clinical clerkships, clinical teachers, and clinical rotation coordinators in the Faculty of Medicine, Universitas Indonesia (FMUI), selected through a maximum variation sampling approach. Triangulation was done through document study. Data were analysed using a thematic analysis approach. Seven focus groups and four in-depth interviews were conducted, and data saturation was reached. Students use feedback through a process of identifying, receiving, and acting on feedback. Performance was used as an indicator to identify feedback. Receiving feedback was found to be a process involving emotional reaction, reflection on feedback content, and reflection on performance. This process resulted in the acceptance or rejection of feedback, also memorising or disregarding the feedback. Accepted feedback was acted upon by formulating an action plan, applying feedback, note-taking, and reading further references. This study proposes a holistic process of how students use feedback in clinical settings, which should be acknowledged in taking steps toward effective feedback through faculty development, student engagement, and developing a feedback culture.