title: Utilising feedback from patients and their families as a learning strategy in a Foundation Degree in palliative and supportive care: a qualitative study.
abstract: BACKGROUND
  In the UK, support workers provide much of the care that palliative care patients receive, and a novel Foundation Degree was developed to enhance their skills. Feedback on performance is a recognised educational tool that reinforces good practice, and gives insight into areas of weakness, but its use with this workforce has not been described.
  
  
  OBJECTIVE
  The aim of this qualitative study is to explore tutor and support workers' experiences of seeking and receiving feedback from patients and their families; focusing on its values and challenges.
  
  
  METHODS
  Support workers enrolled onto the Foundation Degree in Palliative and Supportive Care, were asked to seek feedback from patients and/or their families about the care that they provided using a 'My Experience' questionnaire. Forms were returned anonymously to the course tutor who discussed results with the student as a formative education strategy. The students' experience of this was explored in focus group interviews at three time points. Two tutors' experiences were similarly explored. Results were analysed thematically.
  
  
  RESULTS
  Students enjoyed receiving feedback. Positive feedback helped to increase confidence, and negative feedback allowed students to look critically at their practice and identify areas of weakness. Some experienced challenges in approaching patients/families due to having a small number of suitable patients/families; a reluctance to burden patients; high patient turnover and brevity of care relationships. The tutors enjoyed delivering feedback, recognising its benefits as an educational strategy. Some concern was expressed about how to balance delivering negative feedback while continuing to provide tutorial support throughout the Foundation Degree.
  
  
  CONCLUSIONS
  User feedback is considered a key formative educational strategy. Its use in health and social support workers is not established. The experiences of students and tutors in this Foundation Degree demonstrate some of the benefits and challenges of this as an educational strategy.
authors.affiliation: Palliative Medicine Registrar, LOROS Hospice, Groby Road, Leicestershire LE3 9QE, United Kingdom. Electronic address: laurarowlands@doctors.org.uk.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Pal
authors.affiliation: Dove House Hospice, Chamberlain Road, Hull HU8 8DH, United Kingdom. Electronic address: r.dixon@dovehouse.org.uk.
authors.forename: Rachael E
authors.initials: RE
authors.lastname: Dixon
authors.affiliation: LOROS Hospice, Groby Road, Leicestershire LE3 9QE, United Kingdom. Electronic address: christinafaull@loros.co.uk.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Faull
mesh_terms: D005190:Family; D005246:Feedback; D017144:Focus Groups; D064946:Hospice and Palliative Care Nursing / Q000193:education*; D006801:Humans; D007858:Learning; D010166:Palliative Care; D017060:Patient Satisfaction; D010361:Patients; D036301:Qualitative Research; D000068217:Social Workers / Q000193:education; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Feedback; Foundation Degree; Health and social support workers; Learning; Palliative care; Qualitative; User involvement