COMPARISON OF FACULTY VERSUS STRUCTURED PEER FEEDBACK: IMPLICATIONS OF TECHNICAL SKILLS TRAINING
The surgical training environment has been required to adapt to multiple changes in recent years. Two challenges have placed significant burdens on traditional training methodology: the emerging need for critically reflective clinicians, and restrictions in the traditional methods of technical skills training. Implementing training for these disparate elements is challenging. Simulation-based training has been widely used to teach both technical and non-technical skills to medical students and residents, however consistent access to faculty feedback during training and implementation of critically reflective activities remains problematic. Self-regulated learning can be used to both provide the mechanism by which skill acquisition and critical reflection can occur. This research consisted of two complimentary studies examining technical skill acquisition and self-regulated learning in medical students using structured peer-feedback to learn technical skills. The technical skills study consisted of two prospective randomized controlled trials comparing structured peer-feedback versus traditional faculty feedback for the acquisition of a technical skill. Participants in the peer-feedback group provided feedback to each other using a structural process taught through pre-training with an assessment tool. Participants completed five attempts at the skill over four days. Performance in the peer-feedback group was found to be non-inferior to the faculty group across all assessment criteria used in the study: blinded expert assessment, time to completion and functional test. The impact on self-regulated learning was examined using thematic analysis of student responses to multiple surveys and the written feedback provided by the peer-feedback group. Students developed increasingly sophisticated assessment and feedback skills through regular small exposures to the assessment task. Evidence of self-regulated learning was demonstrated by students’ improvement in technical performance, evaluative judgement of their peer’s performance, self-identification of the benefit of these assessment skills to their own learning, and subsequent implementation of these skills in other contexts. Despite improved assessment skills students did not believe the feedback they provided was beneficial – likely due to a lack of external feedback on their assessment skills from faculty. This research has demonstrated that with appropriate support, structured peer-feedback can be used to augment traditional faculty led training, whilst additionally developing students’ evaluative judgement and self-regulated learning.
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