Title: Impact of Feedback on the Performance of Undergraduate Medical Students in the Practical Classes- A Comparative Study

Authors: Dr Vaidehi.A, Dr Kavitha S, Dr Deepika K, Dr Arun Kumar.T

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.01

Abstract

Medical teachers have serious concern about the decline in practice skills of undergraduate medical students. Feedback as a process improve students knowledge and skills toward Ziehl Neelsen (ZN) staining method. This study was performed to identify the areas of concern while performing ZN staining and to assess the effect of feedback on practical skills during microbiology postings. This interventional comparative study was conducted in the department of microbiology on 130 students. Their competency on ZN staining method was analysed through the questionnaires, observation and oral assessment in the first and second session. Effect of feedback was evaluated in the second session. The areas of knowledge gap assessed through oral assessment, observation and questionnaires was about “the unique acid fast nature of mycobacteria” (0.75+0.41), and “grading of smear as per RNTCP”(3.32+0.86) respectively. Formative assessment had a statistically significant difference between the test scores and performance of students (p<0.001). The perception of students based on the questionnaire was statistically significant (p<0.001). Formative evaluation helps identify the students strengths and weaknesses. Feedback provide learners with information on past performance and helps enhance their knowledge, attitude and practical skills. Interactive and timely feedback has a beneficial effect on students performance.

Keywords: Formative assessment, feedback, medical education, practical skills, staining.

References

  1. Ende J. Feedback in clinical medical education. JAMA 1983;250:777‑81.
  2. Bell B, Cowie B. The Characteristics of Formative assessment in Science Education Sci Educ 2001; 85: 536-53.
  3. Hattie J. Teachers Make a Difference: What is the Research Evidence? 2003. Available from:https://www.cdn.auckland.ac.nz/assets/education/hattie/docs/

teachers‑make‑a‑difference‑ACER‑(2003).pdf. [Last accessed on 2015 Oct 20].

  1. Kluger AN, DeNisi A. The effects of feedback interventions on performance: A historical review, a meta analysis, and a preliminary feedback intervention theory. Psychol Bull 1996;119:254‑84
  2. Epstein RM. Assessment in medical education. New England Journal of Medicine. 2007 Jan 25; 356 (4):387-96.
  3. Archer JC. State of the science in health professional education: effective feedback. Med Educ 2010;44:101-8.
  4. World Health Organization. Tuberc-ulosis fact sheet no. 104. Geneva:

World Health Organization; 2010 [cited 2011 Jul 26]. Available from:

http://www.who.int/mediacentre/factsheets/fs104/en/index.html

  1. Centers for Disease Control. Plan to combat extensively drug-resistant

tuberculosis: recommendations of the Federal Tuberculosis Task Force.CDC 2009. MMWR Recomm Rep 2009; 58: 1–43.

  1. Harakuni SU, Dandannvar V, Mallapur MD. A seven-step approach to master the practical skills in microbiology among 2nd year medical undergraduates: A randomized control trial. Indian j health sci 2016;9:101-7.
  2. Hill DA, Guinea AI, McCarthy WH. Formative assessment: a student perspective. Med Educ 1994 Sep; 28 (5):394-9
  3. Chur-Hansen A. Medical students' essay-writing skills: criteria-based self- and tutor-evaluation and the role of language background. Med Educ. 2000 Mar; 34 (3):194-8.
  4. Henly DC. Use of Web-based formative assessment to support student learning in a metabolism/ nutrition unit. Eur J Dent Educ. 2003 Aug; 7 (3):116-22
  5. Ker J, Mole L, Bradley P. Early introduction to interprofessional learn-ing: a simulated ward environment. Med Educ. 2003 Mar; 37 (3):248-55.
  6. Gipps CV.What is the role for ICT‐based assessment in universities? Studies in Higher Education.2005 Aug 20; 30 (2):171-80
  7. Gibbs G, Simpson C. Conditions under which assessment supports students’ learning. Learning and teaching in higher education. 2004(1):3-31.
  8. Tabbish SA.Assessment Methods in Medical Education. Int J Health Sci (Qassim). 2008 Jul; 2(2): 3–7.
  9. Irby DM, Wilkerson L. Educational Innovations in Academic Medicine and Environmental Trends. Journal of General Internal Medicine. 2003; 18 (5):370-376.
  10. Fahnert B. Edging into the future: education in microbiology and beyond. FEMS Microbiol Lett. 2016;363(7).
  11. Horne DJ, Royce SE, Gooze L, et al. Sputum monitoring during tuberculosis treatment for predicting outcome: syste-matic review and meta-analysis. Lancet Infect Dis. 2010;10(6):387-94.
  12. Milan FB, Parish SJ, Reichgott MJ. A model for educational feedback based on clinical communication skills strategies: beyond the "feedback sandwich". Teach Learn Med. 2006 Winter;18(1):42-7.
  13. Van Hell EA, Kuks JB, Raat AN, Van Lohuizen MT, Cohen-Schotanus J. Instructiveness of feedback during clerkships: influence of supervisor, observation and student initiative.Med Teach.2009 Jan;31(1):45-50.
  14. Greenberg LW. Medical students' perceptions of feedback in a busy ambulatory setting: a descriptive study using a clinical encounter card.  South Med J. 2004 Dec;97(12):1174-8.
  15. Brazeau C, Boyd L, Crosson J. Changing an existing OSCE to a teaching tool: the making of a teaching OSCE. Acad Med. 2002 Sep;77(9):932.
  16. Arun Kumar T, Sangeeta A, Rashmi R, Jyothi S. Effect of formative assessment on documentation of pediatric physical examination by undergraduate medical students. Int J Pediatr Res. 2017;4(10): 603-610.
  17. Martínez-Gonzalez A, et al.: Diagnostic and formative assessment of competencies at the beginning of undergraduate medical internship. Gac Med Mex. 2017;153:4-12.
  18. Sheehan D, Wilkinson TJ, Billett S. Interns' participation and learning in clinical environments in a New Zealand hospital. Acad Med. 2005 Mar; 80 (3):302-8.
  19. Marco Aurélio Floriano PiantolaAna Carolina Ramos Moreno, Adopt a Bacterium – an active and collaborative learning experience in microbiology based on social media. Braz J Microbiol. 2018 Oct-Dec; 49(4): 942–948.
  20. Lipson SM, Gair M. The recording of student performance in the microbiology laboratory as a training, tutorial, and motivational tool. J Microbiol Biol Educ 2011;12:48-50.
  21. Pusic MV, Kessler D, Szyld D, Kalet A, Pecaric M, Boutis K. Experience curves as an organizing framework for deliberate practice in emergency medicine learning. Acad Emerg Med. 2012Dec;19(12):1476-80.
  22. Manjula A, Shashikala P, Nagaraj P. students perception on objective structured practical examination in pathology. J Med Educ Res. 2013;1:12-4.

Corresponding Author

Dr Kavitha Shanker

Assistant Professor, Department of OBG, KFMSR, Coimbatore, TN-641032, India

Mobile: 9894076566, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.