Student Responses to Feedback versus Affirmation versus Both in Suturing Skills: A Qualitative Study

Introduction: Prior studies have compared outcomes in student performance and satisfaction on suturing skills following instruction with constructive feedback compared to compliments, however, there is limited research on using a combination approach.The purpose of this study is to qualitatively explore the experiences of medical students receiving suturing and knot-tying instruction from surgeons utilizing compliments only, constructive feedback only, or a combination approach.Methods: We performed a randomized controlled trial of medical students, physician assistant students, and pre-medical students.Students were randomly assigned to one of three groups: Feedback only (F), compliment only (C), and a combination of feedback and compliments (FC).Each group was taught to perform a simple interrupted suture with a two-handed square knot tie utilizing to their assigned instructional technique.Afterward, they participated in a semi-structured focus group regarding their perceptions of the experience and their satisfaction with and effectiveness of their instructional method.Qualitative focus group data were thematically analyzed using an inductive approach.Results: Feedback in the FC group was overall more positive.Themes included reduced anxiety, more enjoyment, and a feeling of personal achievement.In comparison, neither the C or F groups felt satisfied with their instruction.Themes included inadequate frequency of feedback, specificity of feedback, and overall frustration.Both C and F groups desired more specific feedback to help them improve, as well as a higher frequency of corrective feedback.Most students in these groups felt frustrated that the learning experience did not meet their educational expectations as compared with learners in the FC group.Conclusion: Students receiving instruction in suturing technique that utilizes both constructive feedback and compliments enjoyed the task more and experienced less anxiety and frustration with the task compared to receiving compliments or feedback alone.Both C and F groups expressed desire for more corrective feedback, which was not mentioned in the FC group.