Instructiveness of feedback during clerkships: Influence of supervisor, observation and student initiative

Background: Several authors assume that the supervisor's role, observation of behaviour and students' active participation are important factors in the instructiveness of feedback. Aim: 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 (specialists = 0.862, p 0.01; 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 (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 (student = 0.441, p 0.01; 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.