title: Instructiveness of feedback during clerkships: influence of supervisor, observation and student initiative.
abstract: BACKGROUND
  Several authors assume that the supervisor's role, observation of behaviour and students' active participation are important factors in the instructiveness of feedback.
  
  
  OBJECTIVE
  This study aims to provide empirical evidence for these expectations.
  
  
  METHODS
  For two weeks, 142 clerks from eight hospitals recorded for each individual feedback event: who provided the feedback, whether the feedback was based on observation of behaviour, who initiated the feedback moment and the perceived instructiveness of the feedback. Data were analysed with multilevel techniques.
  
  
  RESULTS
  The perceived instructiveness of feedback provided by specialists and residents did not differ significantly. However, both were perceived to be more instructive than feedback from nursing and paramedical staff (beta(specialists) = 0.862, p < 0.01; beta(residents) = 0.853, p < 0.01). Feedback on behaviour that had been directly observed was reported to be more instructive than feedback on behaviour that had not been observed (beta(observed) = 0.314, p < 0.001). Feedback which stemmed from student initiative or a joint initiative was experienced to be more instructive than feedback which ensued from the supervisor's initiative (beta(student) = 0.441, p < 0.01; beta(joint) = 0.392, p < 0.01).
  
  
  CONCLUSIONS
  The expectations concerning the influence of observation and student initiative on the instructiveness of feedback were confirmed in this empirical study. Expected differences in instructiveness between feedback from specialists and residents were not confirmed.
authors.affiliation: Center for Research and Innovation in Medical Education, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands. E.A.van.Hell@med.umcg.nl
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Van Hell
authors.forename: Jan B M
authors.initials: JB
authors.lastname: Kuks
authors.forename: A N Janet
authors.initials: AN
authors.lastname: Raat
authors.forename: Mirjam T
authors.initials: MT
authors.lastname: Van Lohuizen
authors.forename: Janke
authors.initials: J
authors.lastname: Cohen-Schotanus
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002982:Clinical Clerkship / Q000379:methods*; D002983:Clinical Competence; D005180:Faculty, Medical / Q000458:organization & administration; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education; D008875:Middle Aged; D009426:Netherlands; D010379:Peer Group; D010559:Personnel Management / Q000379:methods*; D013337:Students, Medical; D011795:Surveys and Questionnaires; D055815:Young Adult