The Importance of Real-Time Feedback in Undergraduate Assessments

Sharma, Neel MD

doi: 10.1097/ACM.0b013e3182a8b365
Letters to the Editor

Honorary tutor, Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong;

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To the Editor:

As undergraduates, students face a barrage of formal assessments in many forms, including single-best-answer questions, extended matching, short answer questions, and OSCEs. Preparing for these assessments is no easy task, and the relief that comes from completing them successfully is certainly hard to describe. Although learners may progress to the next stage after passing an assessment, it is quite clear that they often receive very little actual feedback about their performance. Passing an assessment does not necessarily mean full attainment of knowledge, so shouldn’t students be informed of the questions they answered incorrectly or the OSCE stations in which they did less well? After all, when it comes to patient care, we must encourage students to learn from their mistakes even if they have managed to “tick the box” for that year. Feedback should be actively encouraged and should be provided to learners in real time to enhance clinical care.

So, what exactly is feedback? Carless et al1 define feedback as “Dialogic processes and activities which can support and inform the student on the current task, whilst also developing the ability to self-regulate performance on future tasks.” Following from this concept, once pencils are down and answer sheets are handed in, there is no harm in reviewing the answers on the question paper or detailing what exactly was the murmur heard in the cardiovascular station. Doing so could even lead to an open forum where, if students felt that certain questions were badly worded or certain signs were hard to detect, they could subsequently express their opinion on the matter. After all, many of today’s exams are written by senior experts in the field and could easily be misaligned with what is clinically relevant today, with what is implied by a particular question, or, more important, with what is expected of today’s students. This process would surely be of benefit not only for the student but also for the teacher.

An unfortunate characteristic of medical school is the continuing emphasis on grades and formal assessments. Of course, I don’t question the importance of passing exams, but if we continue to paint our feedback in broad strokes, the next generation of doctors will stand no chance of mastering the art of medicine.

Neel Sharma, MD

Honorary tutor, Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong;

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1. Carless D, Salter D, Yang M, Lam J. Developing sustainable feedback practices. Stud Higher Educ. 2011;36:395–407
© 2013 by the Association of American Medical Colleges