Student Perceptions of Formative Clinical Feedback During Clerkships

Abstract The clerkship phase of medical school is essential to the development of clinical skills necessary for medical practice. This phase depends heavily on formative feedback to help students recognize and address their strengths and weaknesses. Recent student evaluation of formative clinical feedback at Saint Louis University revealed a potential barrier in student implementation of feedback due to negative perceptions of the accuracy and utility of the formative feedback they received. Using Norcini et al.’s Consensus Framework for Good Assessment, we developed a survey to investigate the medical student perception of our institution’s current system of formative feedback. Participants included 300 students in their third and fourth year medical students who had completed the clerkship phase. Response patterns indicated that, across years, Feasibility was rated highest and Catalytic Effect was rated lowest. Additionally, the only item rated higher than neutral was Feasibility, whereas Catalytic Effect, Equivalence, Acceptability, and Consistency were rated significantly below neutral. The patterns of results indicate (1) the practicality of the current formative feedback survey format and (2) students’ reduced perception of the usefulness of the formative clinical feedback they receive. While this student perception is subjective in nature, it is a key metric to consider as perception has the potential to drive behavioral change. Other medical schools can consider examining their process and student perception of formative feedback using a framework of assessment similar to the Norcini framework to promote continuous quality improvement in undergraduate medical education.