Formative Feedback Passport: A Tool to Engage Students in Reflecting on and Incorporating Mid-Point Feedback




Postma, Heather Elizabeth

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BACKGROUND: The importance of formative feedback in undergraduate medical education is widely appreciated; however, it is historically inadequate. The formative feedback passport (FF tool) was developed and implemented in the Internal Medicine (IM) clerkship at UT Southwestern to address these concerns. OBJECTIVE: This dissertation examines the FF tool's role in facilitating an optimal formative feedback process. METHODS: Initially, a pre-intervention study was conducted, in which randomly selected, de-identified FF tools from the 2018-2019 IM clerkship were analyzed for content and quality of student reflection. Results revealed that student reflection on feedback was insufficient, with transformative, thoughtful reflection seldom occurring. In response to these findings, the FF tool's instructions were augmented with a module to encourage critical reflection. Subsequently, a post-intervention study was conducted, in which randomly selected, de-identified FF tools from the 2020-2021 IM clerkship were analyzed in the same manner as the pre-intervention study. RESULTS: 149 feedback tips from 50 FF tools were included in the pre-intervention study, and 162 feedback tips from 54 FF tools were included in the post-intervention study for a total of 311 feedback tips from 104 FF tools analyzed. In both studies, most of the feedback tips aligned with established standards for resident and faculty evaluators. In addition, the mean scores for each REFLECT Rubric criterion were significantly higher in the post-intervention group than the pre-intervention group. CONCLUSION: The FF tool is an invaluable electronic feedback tool in the IM clerkship at UT Southwestern. It enables documentation of formative feedback and promotes critical student engagement, reflection upon feedback, and the development of plans to implement feedback for improvement. Study results demonstrate that students receive formative feedback from an attending, resident, or patient that is appropriate in content. Additionally, study results demonstrate that the intervention improved student engagement and quality of reflection on feedback using the FF tool.

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