Document Type : Original Article

Authors

Pediatric Cardiovascular Research Center, ICRI, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

INTRODUCTION: Given the importance of feedback to improve teachers’ educational performance,
the current study aimed to identify the challenges and problems involved in providing feedback to
clinical teachers on their educational performance.
MATERIALS AND METHODS: In the first phase of this mixed‑methods study, the clinical teachers,
students, and university officials were interviewed on feedback problems and challenges. After
an inductive content analysis, and based on the problems enlisted, a ten‑item questionnaire was
developed. Subsequently, 25 clinical teachers completed the questionnaire by scoring the importance
and urgency of each problem.
RESULTS: Overall, 18 individual and group interviews were conducted with 24 people. A total
of ten themes and five categories emerged, including “lack of transparency of feedback system,”
“absence of criticizability culture,” “lack of motivation to improve performance,” “failure to consider
factors affecting teacher’s performance,” “lack of formative evaluation,” “inappropriate data obtained
on teacher’s performance,” “inappropriate feedback providers,” “inappropriate feedback recipients,”
“inappropriate feedback provision,” and “no feedback follow‑up.” Three items of priority involved
“inappropriate feedback providers,” “inappropriate data,” and “failure to consider factors affecting
the teacher’s performance.”
CONCLUSIONS: All the raised problems obtained high scores; nevertheless, the interviewees had
more problems with the feedback provider, the data collected on the performance, and inattention
of university officials to the factors influencing performance than feedback presentation methods.
Hence, gaining the trust of teachers on the collected data, providing feedback by their trustworthy
individuals, and paying attention to the factors influencing teachers' performance are associated with
an increased possibility of feedback acceptance.

Keywords

  1. DeNisi AS, Murphy KR. Performance appraisal and
    performance management: 100 years of progress? J Appl Psychol
    2017;102:421‑33.
    2. Isfahan University of Medical Sciences [internet]. Isfahan:
    Eduation Development Center. [Cited 2018 Jan 21]. Office of
    Teacher Evaluation Available from: http://www.edc.mui.ac.ir/
    fa/%D9%88%D8%A7%D8%AD%D8%AF‑%D8%A7%D8%B1%D
    8%B2%D8%B4%DB%8C%D8%A7%D8%A8%DB%8C‑%D8%A7%
    D8%B3%D8%A7%D8%AA%DB%8C%D8%AF.
    3. Yamani N, YousefyA, Changiz T. Proposing a participatory model
    of teacher evaluation. Iran J Med Educ 2006;6:115‑21.
    4. Goldfarb S, Morrison G. Continuous curricular feedback:
    A formative evaluation approach to curricular improvement.
    Acad Med 2014;89:264‑9.
    5. Shakurnia A. Faculty attitudes towards student ratings: Do the
    student rating scores really matter? Iran J Med Educ 2011;11:84‑93.
    6. Yarmohammadian M, Bahrami S, Foroughi Abri A. Educational
    Administration and Planning: Isfahan University of Medical
    Sciences; 2010.
    7. Saif AA. Educational Measurement, Assessment and Evaluation.
    Tehran: Doran Publications; 2004. p. 128.
    8. Boerboom TB, Jaarsma D, Dolmans DH, Scherpbier AJ,
    Mastenbroek NJ, Van Beukelen P, et al. Peer group reflection
    helps clinical teachers to critically reflect on their teaching. Med
    Teach 2011;33:e615‑23.
    9. Haghani F, Fakhari M. Feedback in clinical education: Concept,
    barriers, and strategies. Iran J Med Educ 2014;13:869‑85.
    10. Hattie J, Timperley H. The power of feedback. Rev Educ Res
    2007;77:81‑112.
    11. Dinmohammadi MR, Jalali A, Bastani F, Parvizi S, Borimnejhad L.
    Bazkhord: Onsore asasie amoozeshe balini (vazhehnameh tosifi).
    Iran J Med Educ2001;9:5.
    12. Santiago P, Benavides F. Teacher evaluation: A conceptual
    framework and examples of country practices. OECD Review on
    Evaluation and Assessment Frameworks for Improving School
    Outcomes; 2009. p. 1‑2.
    13. OCDE, OCDE. Teachers for the 21st Century. Using Evaluation
    to Improve Teaching. París: OECD Publishing; 2013.
  2. 14. Saif AA. Modern Educational Psychology. 6th ed. ،Tehran: Dowran
    publication; 2009.
    15. Stronge JH. Evaluating Teaching. A Guide to Current Thinking
    and Best Practice.California: Corwin Press; 2006.
    16. Nolan J Jr., Hoover LA. Teacher Supervision and Evaluation:
    theory into practice. Hoboken, New Jersey: John Wiley and Sons;
    2011.
    17. Marten JL. To whom do they turn? Expert Teachers’ Experiences
    with Feedback [dissertation]. Wisonsin: Marian University; 2015.
    18. Lyon HC Jr., Holzer M, Reincke M, Brendel T, Ring J, Weindl A,
    et al. Improvements in teaching behavior at two German medical
    schools resulting from a modified flanders interaction analysis
    feedback intervention process. Med Teach 2014;36:903‑11.
    19. Springgay S, Clarke A. Mid‑course feedback on faculty teaching:
    a pilot project. In: Farr Darling L, Erickson G, Clarke A. Collective
    Improvisation in a Teacher Education Community. Dordrecht:
    Springer; 2007. p. 171‑84.
    20. Kluger AN, DeNisi A. The effects of feedback interventions
    on performance: A historical review, a meta‑analysis, and
    a preliminary feedback intervention theory. Psychol Bull
    1996;119:254.
    21. DeNisi AS, Kluger AN. Feedback effectiveness: Can 360‑degree
    appraisals be improved? Acad Manage Exec 2000;14:129‑39.
    22. Ministry of Health and Medical Education, Education
    Development Center [internet]: Accreditation standards for
    Medical Education Development Centers 2012 [in Persian] [cited
    208 Jan 12]. Available from: http://edc.behdasht.gov.ir/page/
    %D9%86%D8%B8%D8%A7%D8%B1%D8%AA+%D9%88+%D
    9%BE%D8%A7%D9%8A%D8%B4+%D9%85%D8%B1%D8%A7
    %D9%83%D8%B2
    23. Iman M, Noushadi M. Qualitaive content analysis. Pazhouhesh
    2012;3:15‑44.
    24. Graneheim UH, Lundman B. Qualitative content analysis in
    nursing research: Concepts, procedures and measures to achieve
    trustworthiness. Nurse Educ Today 2004;24:105‑12.
    25. Isfahan university of medical sciences, Education Development
    center: Regulations and Guidelines [internet]. Ayeennamehye
    nezame jameae arzeshyabiye keifiyyat [in Persian][cited
    2018 Jan 12]. Available from: http://edc.mui.ac.ir/fa/%D8%A2
    %D8%A6%DB%8C%D9%86‑%D9%86%D8%A7%D9%85%D9%8
    7‑%D9%87%D8%A7‑%D8%B1%D8%A7%D9%87%D9%86%D9%
    85%D8%A7%D9%87%D8%A7.
    26. Medical school, Isfahan University of Medical sciences [internet].
    Standards in clinical education [cited 2018 Jan 12]. Available from:
    http://med.mui.ac.ir/?q=content/%D8%A7%D8%B3%D8%AA
    %D8%A7%D9%86%D8%AF%D8%A7%D8%B1%D8%AF%D9%8
    7%D8%A7%DB%8C‑%D8%B9%D8%B1%D8%B5%D9%87‑%D9%
    87%D8%A7%DB%8C‑%D8%A2%D9%85%D9%88%D8%B2%D8
    %B4‑%D8%A8%D8%A7%D9%84%DB%8C%D9%86%DB%8C
    27. Jalili M, Khabaz Mafinejad M, Gandomkar R, Mortaz Hejri S.
    Principles and Methods of Student Assessment in Health
    Professions. 1st ed. Tehran: The Academy of Medical Sciences; 2017.
    28. Nicol DJ, Macfarlane-Dick D. Formative assessment and
    self-regulated learning: A model and seven principles of good
    feedback practice. Stud Higher Educ 2006;31:199‑218.
    29. Ramani S, Post SE, Könings K, Mann K, Katz JT, van der Vleuten C,
    et al. “It’s just not the culture”: A qualitative study exploring
    residents’ perceptions of the impact of institutional culture on
    feedback. Teach Learn Med 2017;29:153‑61.
    30. Watling C, Driessen E, van der Vleuten CP, Lingard L. Learning
    culture and feedback: An international study of medical athletes
    and musicians. Med Educ 2014;48:713‑23.
    31. Curtis DA, O’Sullivan P. Does trainee confidence influence
    acceptance of feedback? Med Educ 2014;48:943‑5.
    32. Perrella A. Room for improvement: Palliating the ego in
    feedback‑resistant medical students. Med Teach 2017;39:555‑7.
    33. Ende J. Feedback in clinical medical education. JAMA
    1983;250:777‑81.
    34. Leung K, Su S, Morris MW. When is criticism not constructive?
    The roles of fairness perceptions and dispositional attributions in
    employee acceptance of critical supervisory feedback. Hum Relat
    2001;54:1155‑87.
    35. van de Ridder JMM, Berk FCJ, Stokking KM, Ten Cate OTJ.
    Feedback providers’ credibility impacts students’ satisfaction with
    feedback and delayed performance. Med Teach 2015;37:767‑74.
    36. van de Ridder JM, McGaghie WC, Stokking KM, ten Cate OT.
    Variables that affect the process and outcome of feedback,
    relevant for medical training: A meta‑review. Med Educ
    2015;49:658‑73.
    37. Mann K, van der Vleuten C, Eva K, Armson H, Chesluk B,
    Dornan T, et al. Tensions in informed self‑assessment: How the
    desire for feedback and reticence to collect and use it can conflict.
    Acad Med 2011;86:1120‑7.
    38. Aguinis H, Gottfredson RK, Joo H. Delivering effective
    performance feedback: The strengths‑based approach. Bus
    Horizons 2012;55:105‑11.
    39. 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. Med Teach
    2006;28:117‑28.