What motivates the post-graduate medical trainee in seeking feedback?

Abstract

Background This study focuses on the post-graduate trainee during implementation of competency-based medical education (CBME). Based on social and organisational psychology theoretical models, using a goal-orientation theory framework, this study aims to explore how goal-orientation affects postgraduate medical trainees' feedback-seeking behaviour and preferences. Methods This sequential mixed methods study employs quantitative "profiling" of post-graduate trainees into categories based on a goal-orientation questionnaire, and then explores whether learner "profile" affects feedback-seeking behaviours through goal-orientation specific, semi-structured group interviews. Results 213 of 974 questionnaires were completed which identified 90 respondents having a preferred goal orientation; either Learn, Performance-Avoid (Avoid), or Performance-Prove (Prove). 4 Learn, 3 Avoid, and 3 Prove participants were interviewed. Responses were from a representative sample of post-graduate medical trainees. Five themes were identified: dominance of summative assessment or "judgement", dependent learning, self-direction, goal-setting, and relationship or "trust". Discussion Findings suggest that those who have a learning goal-orientation seem more likely to use goal-setting and self-directed learning strategies than those in either of the performance goal-orientation groups. Avoid and Prove learners were more likely to view feedback as judgements and be dependent learners. A conceptual framework was developed and highlights that regardless of goal-orientation, the teacher-learner relationship was paramount to feedback receptivity. In particular, trust in the dyad enables the learners to expose weaknesses leading to more effective feedback. These findings can help optimize CBME feedback and assessment tools and may also have implications for resident workshops on self-assessment, goal-setting, and on the creation of faculty development workshops on giving feedback. This study focuses on the post-graduate trainee during implementation of competency-based medical education (CBME). Based on social and organisational psychology theoretical models, using a goal-orientation theory framework, this study aims to explore how goal-orientation affects postgraduate medical trainees' feedback-seeking behaviour and preferences. This sequential mixed methods study employs quantitative "profiling" of post-graduate trainees into categories based on a goal-orientation questionnaire, and then explores whether learner "profile" affects feedback-seeking behaviours through goal-orientation specific, semi-structured group interviews. 213 of 974 questionnaires were completed which identified 90 respondents having a preferred goal orientation; either Learn, Performance-Avoid (Avoid), or Performance-Prove (Prove). 4 Learn, 3 Avoid, and 3 Prove participants were interviewed. Responses were from a representative sample of post-graduate medical trainees. Five themes were identified: dominance of summative assessment or "judgement", dependent learning, self-direction, goal-setting, and relationship or "trust". Findings suggest that those who have a learning goal-orientation seem more likely to use goal-setting and self-directed learning strategies than those in either of the performance goal-orientation groups. Avoid and Prove learners were more likely to view feedback as judgements and be dependent learners. A conceptual framework was developed and highlights that regardless of goal-orientation, the teacher-learner relationship was paramount to feedback receptivity. In particular, trust in the dyad enables the learners to expose weaknesses leading to more effective feedback. These findings can help optimize CBME feedback and assessment tools and may also have implications for resident workshops on self-assessment, goal-setting, and on the creation of faculty development workshops on giving feedback.