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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

‘I’m never going to change unless someone tells me I need to’: fostering feedback dialogue between general practice supervisors and registrars

Bianca Denny A C , James Brown A , Catherine Kirby A , Belinda Garth A , Janice Chesters A and Debra Nestel B
+ Author Affiliations
- Author Affiliations

A EV GP Training (EVGPT), Suite B2, 50 Northways Road, Churchill, Vic. 3842, Australia.

B Monash Institute for Health and Clinical Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, Vic. 3168, Australia.

C Corresponding author. Email: bianca_denny@me.com

Australian Journal of Primary Health 25(4) 374-379 https://doi.org/10.1071/PY19037
Submitted: 6 February 2019  Accepted: 19 May 2019   Published: 13 August 2019

Abstract

Feedback is often unidirectional and focused on learners receiving feedback. Learning relationships are viewed as influential to promoting feedback dialogue. The aim of this study was to explore factors that facilitate or impede feedback between general practice supervisors and registrars. An in-depth qualitative study was conducted. Data collection featured semistructured interviews with registrars (n = 9) and supervisors (n = 5). Interviews were audio recorded and analysed interpretatively. Feedback was affected by personal (i.e. resilience, humility), relational (i.e. strength of supervisory relationship, power differentials) and contextual (i.e. culture) factors. Registrars are not accustomed to providing feedback and supervisors do not typically request feedback. Past feedback experiences affect registrar engagement in feedback exchanges. A culture of feedback dialogue within training organisations and training practices is essential. Power imbalance needs to be addressed, particularly for feedback by registrars. Strategies to develop feedback skills and promote an open feedback culture are essential.


References

Algiraigri AH (2014) Ten tips for receiving feedback effectively in clinical practice. Medical Education Online 19, 25141
Ten tips for receiving feedback effectively in clinical practice.Crossref | GoogleScholarGoogle Scholar | 25079664PubMed |

Bing-You R, Hayes V, Varaklis K, Trowbridge R, Kemp H, Mckelvy D (2017) Feedback for learners in medical education: what is known? A scoping review. Academic Medicine 92, 1346–1354.
Feedback for learners in medical education: what is known? A scoping review.Crossref | GoogleScholarGoogle Scholar | 28177958PubMed |

Boendermaker PM, Conradi MH, Schuling J, Meyboom-De Jong B, Swierstra RP, Mertz JC (2003) Core characteristics of the competent general practice trainer: a Delphi study. Advances in Health Sciences Education: Theory and Practice 8, 111–116.
Core characteristics of the competent general practice trainer: a Delphi study.Crossref | GoogleScholarGoogle Scholar |

Bowen L, Marshall M, Murdoch-Eaton D (2017) Medical student perceptions of feedback and feedback behaviors within the context of the ‘educational alliance’. Academic Medicine 92, 1303–1312.
Medical student perceptions of feedback and feedback behaviors within the context of the ‘educational alliance’.Crossref | GoogleScholarGoogle Scholar | 28272114PubMed |

Cliffe T, Beinart H, Cooper M (2016) The development and validation of a short version of the Supervisory Relationship Questionnaire. Clinical Psychology & Psychotherapy 23, 77–86.
The development and validation of a short version of the Supervisory Relationship Questionnaire.Crossref | GoogleScholarGoogle Scholar |

Creswell J (2013) ‘Qualitative inquiry and research: choosing among five approaches.’ (Sage: Los Angeles)

Dudek NL, Dojeiji S, Day K, Varpio L (2016) Feedback to supervisors: is anonymity really important? Academic Medicine 91, 1305–1312.
Feedback to supervisors: is anonymity really important?Crossref | GoogleScholarGoogle Scholar | 27028033PubMed |

Eva KW, Armson H, Holmboe E, Lockyer J, Loney E, Mann K, Sargent J (2012) Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes. Advances in Health Sciences Education: Theory and Practice 17, 15–26.
Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes.Crossref | GoogleScholarGoogle Scholar |

Hattie J, Timperley H (2007) The power of feedback. Review of Educational Research 77, 81–112.
The power of feedback.Crossref | GoogleScholarGoogle Scholar |

Ingham G, O’Meara P, Fry J, Crothers N (2014) GP supervisors: an investigation into their motivation and teaching activities. Australian Family Physician 43, 808–812.

Lefroy J, Waitling C, Teunissen PW, Brand P (2015) Guidelines: the do’s, don’ts and don’t knows of feedback for clinical education. Perspectives on Medical Education 4, 284–299.
Guidelines: the do’s, don’ts and don’t knows of feedback for clinical education.Crossref | GoogleScholarGoogle Scholar | 26621488PubMed |

Patton MQ (1999) Enhancing the quality and credibility of qualitative analysis. Health Services Research 34, 1189–1208.

Telio S, Regeht G, Ajjari R (2016) Feedback and the educational alliance: examining credibility judgements and their consequences. Medical Education 50, 933–942.
Feedback and the educational alliance: examining credibility judgements and their consequences.Crossref | GoogleScholarGoogle Scholar | 27562893PubMed |

Thomson JS, Anderson KJ, Mara PR, Stevenson AD (2011) Supervision – growing and building a sustainable general practice supervisor system. The Medical Journal of Australia 194, S101–S104.

Watling C, Driessen E, van der Vleuten CP, Lingard L (2012) Learning from clinical work: the roles of learning cues and credibility judgements. Medical Education 46, 192–200.
Learning from clinical work: the roles of learning cues and credibility judgements.Crossref | GoogleScholarGoogle Scholar | 22239333PubMed |

Watling C, Driessen E, Van Der Vleuten CPM, Vanstone M, Lingard L (2013) Beyond individualism: professional culture and its influence on feedback. Medical Education 47, 585–594.
Beyond individualism: professional culture and its influence on feedback.Crossref | GoogleScholarGoogle Scholar | 23662876PubMed |

Wearne S (2016) Effective feedback and the educational alliance. Medical Education 50, 891–892.
Effective feedback and the educational alliance.Crossref | GoogleScholarGoogle Scholar | 27562887PubMed |