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How to get the most out of assessment through feedback
1. CENTRE FOR
MEDICAL
EDUCATION
Centre for Medical Education, The Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF
Tel: 01382 381952 www.dundee.ac.uk/meded
2. How to get the most out
of assessment through
feedback
Dr Rola Ajjawi
Senior Lecturer in Medical Education
Centre for Medical Education
3.
4. Overview
Types of assessment
What is feedback
The feedback gap
Feedback dialogue
How to bridge the feedback gap
5. Two types of assessment1
Summative assessment = assessment of learning
7. BUT is this a useful
distinction…
Why can’t we optimise
learning from all assessment
processes?
8. Influence of feedback2-3
Affective processes of increased
effort and motivation
Cognitive processes of restructuring
knowledge
Learners require reassurance that
they are heading in the right
direction
Constructive feedback often results
in improved performance
9. Definition
“Specific information about the comparison between
a trainees observed performance and a standard,
given with the intent to improve the trainees
performance” 4, p. 193
10. Feedback encapsulates:2
1. Where am I going
2. How am I going
3. Where to next (how do I get there?)
(Hattie and Timperley, 2007)
12. We have a problem…
http://www.motor-trade-insider.com/index.php/2010/11/houston-we-have-a-problem/
13. The feedback ‘gap’
Educators and learners at all levels believe
feedback is valuable for learning
BUT
There is a disparity in educators’ and students’
perception of feedback6
14. Tutors think they provide more detailed feedback than
students perceive
Tutors view their feedback to be more useful
compared to what students think6
15. Why is there a feedback gap?
(and how can we bridge it…)
17. Commonly reported concerns of students
Feedback is too late to influence learning
Feedback is cryptic e.g. “more”
Feedback is jargon heavy and difficult to understand
Feedback provides no explanation for action e.g.
“good”
Good students miss out
Feedback is “one off” – no chance to try again based
on the feedback
Feedback is overwhelming/not enough
… assuming they get any feedback at all!
18. & ignores the relationship…
Interplay between fear, confidence and reasoning
in receptivity to feedback7
Tendency for ‘deflection’ when there is a discrepancy
between learners’ internal perceptions (self-
evaluation) and the external teacher’s perceptions
(feedback)8
Learner re-interprets the external feedback to make
it conform with their own hope, intention or
interpretation of their performance9
Perceived credibility of feedback giver essential10
19.
20. We need to actively involve
our students in feedback
dialogue
“Medical educators may have been too focused on a
narrow view of feedback. Building an approach or
system around a few teacher-specific behavioral
principles (eg, timely, specific) is inadequate. An
approach to improving feedback incorporates teacher-
based behaviors, learner-based cognitive principles,
and a focus on the teacher-learner relationship” 11, p.1331
21. Teacher-based strategies
Faster turnaround of feedback (if it
matters)
Improve quality of the feedback
Explicate timings
Discuss standards and criteria with
your students to ensure clarity
Look at sequencing of assignments
Faculty development and
benchmarking
Establish authentic (not tokenistic)
dialogue
Ask for feedback
24. Learner-based strategies
Educate and empower students to
take an active role in feedback
Engage students in generating
assessment criteria and discussing
standards
Create opportunities for students to
process and use feedback (e.g. self-
explaining)
Engage students in self- and peer-
review
Generate a dialogue about feedback
26. To find out more about our changes…13
http://youtu.be/S5bBFEbXDD0
27. Summary
To get most out of the assessment process you need
FEEDBACK
Feedback should be conceptualised as a dialogical
two-way process that involves coordinated teacher–
student and peer-to-peer interaction as well as active
learner engagement6
Feedback does not need to be the sole responsibility
of teachers
The trainee-supervisor relationship influences the
effectiveness of feedback
28.
29. References
1. Schuwirth L & van der Vleuten (2010). How to design a useful test: principles of assessment. In
Swanwick T Understanding Medical Education (p.195-207). ASME Wiley-Blackwell.
2. Hattie J, Timperley H. The Power of Feedback. Review of Educational Research. 2007;77(1):81-112.
3. Veloski J, Boex JR, Grasberger MJ, Evans A, Wolfson DB. Systematic review of the literature on
assessment, feedback and physicians’ clinical performance: BEME Guide No. 7. Medical Teacher.
2006;28(2):117-28.
4. Van De Ridder JMM, Stokking KM, McGaghie WC, Ten Cate OTJ. What is feedback in clinical education?
Med Educ. 2008;42(2):189-97
5. Norcini, J., & Burch, V. (2007). Workplace-based assessment as an educational tool: AMEE Guide No. 31.
Medical Teacher, 29(9), 855 - 871.
6. Carless D. Differing perceptions in the feedback process. Studies in Higher Education. 2006;31(2):219-
33.
7. Eva K, Armson H, Holmboe E, Lockyer J, Loney E, Mann K, et al. Factors influencing responsiveness to
feedback: on the interplay between fear, confidence, and reasoning processes. Advances in Health
Sciences Education. 2011:1-12.
8. Boud D, Molloy E. Rethinking models of feedback for learning: the challenge of design. Assessment &
Evaluation in Higher Education. 2012:1-15.
9. Watling C, Driessen E, van der Vleuten CPM, Vanstone M, Lingard L. Understanding responses to
feedback: the potential and limitations of regulatory focus theory. Med Educ. 2012;46(6):593-603
10. Carless D, Salter D, Yang M, Lam J. Developing sustainable feedback practices. Studies in Higher
Education. 2011;36(4):395-407
11. Bing-You RG, Trowbridge RL. Why medical educators may be failing at feedback. JAMA.
2009;302(12):1330-1.
12. Russell, M., & Bygate, D. (2010). Assessment for Learning: An introduction to the ESCAPE project.
Blended Learning in Practice, March, 38-48.
13. Ajjawi, R., Schofield, S., McAleer, S., & Walker, D. (2013). Assessment and feedback dialogue in online
distance learning. Medical Education, 47(5), 527-528
Helping students understand their performance and learn
Effective feedback can lead to change in learners through affective processes of increased effort, motivation and engagement, or through cognitive processes including restructuring of knowledge and alternative strategies to understanding (Hattie and Timperley, 2007).Bullet point 2: no feedback can be demotivating.
In a literature review of feedback, van der Ridder identified differing understandings of feedback that varied from information about performance to more comprehensive definitions such as this.What you notice with this definition that is relevant to you in the clinical environment is that feedback needs to be specific, needs to be about performance that is observed (not second hand information) and against a standard of performance.
These three aspects should be present in all feedback encounters and relate to the van der Ridder et al definition in the previous slide. About the learner’s goalsAbout current performanceAbout an action plan to achieve the goals.
By focussing on how the feedback is delivered it ignore an important aspect of the feedback – the learner and the relationship you have with the learner! It also ignore the complexities of communication and how power, identity, self-esteem, previous experiences and background all impact on the way communication occurs and is interpreted.
e.g. point 2 – what does more critique mean when the student doesn’t know how to critique or things they have done it
Effective feedback can lead to change in learners through affective processes of increased effort, motivation and engagement, or through cognitive processes including restructuring of knowledge and alternative strategies to understanding (Hattie and Timperley, 2007).Bullet point 2: no feedback can be demotivating and humiliating.
Bullet-point 1: it matters most when feedback from one assignment should feed into the next assignment and so feedback needs to be given in a timely manner so that students are able to read, think about and develop action plans as a result of the feedback in time to feed into the next assignment before its due date. It should also enable time for students to seek further clarification or discussion of the feedback.
Modular approach to sequencing of assessmentExplicating feedback times in a student-tutor charterDevelopment of assessment rubrics for all summativeIncreased use of formative assessmentsFaculty development around feedback
Student should be asked to summarise the feedback – David Nicol reported that this is analogous to self explanation which Chi et al (1994) report to improve self-monitoring and evaluation. ( For more on self-explaining http://www.learnlab.org/research/wiki/index.php/Prompted_self-explanation_hypothesis) He also reported some work by Cho and MacArthur who showed that students made more complex improvements to their work after receiving feedback from multiple sources. http://psycnet.apa.org/journals/edu/103/1/73.html This list is by no means exhaustive
