Almost universally, papers about feedback open with a claim about its importance. But each paper characterises the problem of feedback in their own way, and this construction of the problem is something worth considering. When I first saw the title of Chuang et al's1 study on desired features of feedback, I wondered what it was that we still needed to establish about the features feedback: Surely, there have been many previous examinations of feedback preferences? And why are we still so interested in feedback? In their findings and discussion, it becomes clear that since residents desire a range of different things in feedback, there may well be several feedback problems still to be addressed. In this commentary, I aim to offer tools towards a deeper consideration of feedback problems. Each paper characterises the problem of feedback in their own way, and this construction of the problem is something worth considering. Chuang et al1 argue that learners' preferences for feedback are important to consider to ensure that feedback conversations are useful for the learning that needs to occur in a high-paced clinical setting in the context of forward-looking professional development. The focus on preferences leads logically to a method that supports prioritisation (the Q-methodology study). Through their engagement with emergency medicine residents, they distil four patterns for feedback priorities, highlighting the need for diversity and flexibility in considering what any learner might need, want or find most effective in a particular setting. Here, it can be seen in the shift from universal maxims about feedback to the specific situations that the characteristics of the problem can differ: How can we move beyond set formulae for feedback towards developing educators who can adapt to what learners might need at a particular moment? This idea—that problems with feedback are not universal—combined with Chuang et al's1 approach to prioritisation within resource constrained environments, offers some useful ways to think about identifying which most urgent and important aspects of the problems with feedback we might aim to research next. How can we move beyond set formulae for feedback towards developing educators who can adapt to what learners might need? Staying with Chuang et al's1 work, they offer a comprehensive account of the recent feedback landscape, covering shifts in research and practice from crafting information towards attending to interactions, processes and mutual engagement and facilitating both educator and student capability. Each of these shifts alters our perspective on what the problems in feedback might be and how they might be approached. To extend this focus on problems a little further, Bacchi's2 analytical approach, ‘What's the problem presented to be’ (abbreviated WPR) can be used to support thinking about how feedback research might be approached. WPR was originally formulated to offer a way into researching and critiquing policy, but is now applied more broadly to situations where problems are characterised, and has occasionally been applied within health professional education contexts.3, 4 WPR offers a helpful step-by-step approach to developing a critical perspective on a topic through a close examination of the premises and framing of an issue to understand how adopting such a perspective leads to particular impacts. Step one is identifying the problem formulation: Chuang et al1 predominantly draw on student feedback literacy5 and the ‘ready, willing and able’ (RWA) model.6 Both of these centre the learner and what they do as pivotal to effective feedback, and thus, we might interpret that the problem might reside with the individual student, their past preparation for feedback encounters and, at a stretch, how others have set them up for these encounters. Emotions are also highlighted in these framings, with a need to consider, manage or even suppress particular feelings, but also a need to motivate and engage learners to do something with the feedback information that is available. RWA also highlights the need for feedback messages to be appropriately relayed through time and space, creating a problem of logistical aspects such as public or private settings, and immediate or delayed feedback. The credibility of sources and how they might be judged are also further problems that might need to be solved. Indeed, one does not have to look very far in the literature to find examples of studies attempting to address these various problems.7-10 Now to step two: What might the underlying assumptions be, when framing the problem of feedback in the above ways and are these valid assumptions? Firstly, feedback should happen, and it will generally have a positive and developmental effect, which might be at odds with Kluger and Denisi's11 meta-analysis identifying negative effects in about a third of studies (and indeed, in our own experiences of feedback that did not have the intended effect). Secondly, learners are also on board with the desire to develop and grow—which might not be true for all students12—and what they want is actually what they need. Thirdly, feedback occurs in particular ways, predominantly between people, with a prioritisation of expert sources. And finally, feedback is a precious and finite resource, which must be prioritised and rationed. This seems to contradict existing shifts towards a learner-centric view of feedback processes, where individuals may seek out feedback information from many sources.8 What might the underlying assumptions be, when framing the problem of feedback in the above ways and are these valid assumptions? When we revisit our assumptions, it offers opportunities for problems to be explored in different ways. Understanding how feedback might worsen performance or outcomes might be important in knowing what things we need to modify or avoid in the way that feedback works, especially for diverse learners. Considering learner goals and desires as diverse and not necessarily aligned with educators' agendas might drive us to consider learners' motivations and conceptualisations of feedback. When considering the expansion of potential information sources to beyond those of supervising educators, we might need to revisit how we support learners to make judgements about the quality and timeliness of messages. There are further prompts to complete a WPR analysis beyond these first two steps, considering the genealogy of problem representation, what is left unproblematised, and the flow-on effects of these particular frames for thinking about a topic. These may all help us approach the issues we experience from new perspectives. When we revisit our assumptions, it offers opportunities for problems to be explored in different ways. So, where does this leave us? While we can continue with our conviction that feedback is important, we also need to consider how we problematise it, depending on our personal experiences, preferences and positioning in epistemological and social landscapes, and what our perspective affords (or does not afford) in addressing problems in practice, or through research. It is unlikely to be productive to declare that one viewpoint, problem approach or even methodology is superior, or more needed than another. As Chuang et al1 highlight is important for feedback practices, responding flexibly to diversity of needs is likely to better support growth and development. We should continue to approach problems in feedback from a range of perspectives (for some useful examples of opening feedback problematisations, see Bearman et al13 and Molloy et al14). While some might matter to us and therefore motivate us more than others, so long as studies and their problematics are formulated on a strong foundation that takes prior knowledge, perspectives and approaches into account, we are likely to be advancing the field and making a valuable contribution. It is unlikely to be productive to declare that one viewpoint, problem approach or even methodology is superior or more needed than another. Joanna Tai: Conceptualisation; writing—original draft; writing—review and editing. Open access publishing facilitated by Deakin University, as part of the Wiley - Deakin University agreement via the Council of Australasian University Librarians No conflicts of interest to declare. This conceptual piece did not require ethical approval since there were no human participants involved. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
Joanna Tai (Thu,) studied this question.