Feedback in Fieldwork

Breanna Chycinski, OTD, OTRL, PNAP�Kelsey Jewett, MSOT, OTRL

Melissa Peters, MOT OTRL

Sheila Guiao, MSOT, OTRL

Today’s Topics

Objectives

By the end of today’s session, participants should be able to:

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Let’s Meet our Incoming Students

Survey creation

Q1: What type of feedback do you feel would be most helpful as a fieldwork student?

Students selected any of 5 responses (as many as applicable) and could provide a write-in response.

Write in responses for Q1: What type of feedback do you feel would be most helpful as a fieldwork student?

• 3 students provided their own responses:
• “Real time feedback – correction of hand placement during a transfer, prompting by the FWed to the student about what else to ask about (‘Knowing this, what would you recommend for discharge planning?’)”
• “I feel like if there is a good balance say it’s not only the negative things being pointed out and there is praise for the good things that are done and educator’s straightforward/clear/constructive feedback will be absorbed/taken better”
• “I think everyone would like to hear something positive but I actually respond the strongest to strict leadership”

Q2: What type of feedback do you feel would be least helpful as a fieldwork student?

Students selected any of 5 responses (as many as applicable) and could provide a write-in response.

Write in responses to Q2: What type of feedback do you feel would be least helpful as a fieldwork student?

• 13 provided their own responses, which can be described in the following categories:
• Only negative or constructive feedback (8 students)
• (“Constructive feedback, vague feedback”; “Not enough or only my weaknesses”)
• Only positive feedback (1 student)
• (“Only positive feedback. There is always room for improvements”)
• Delayed feedback (1 student)
• (“Delayed feedback – ie feedback only at the midterm and final evaluation”)
• Depends on the student, all feedback can be good (3 students)
• (“These are all great forms of feedback, it just depends on the student”)

Comparison: Most and Least Helpful Types of Feedback

Q3: How do you prefer to receive feedback?

Students selected any of 4 responses (as many as applicable).

Q4: When do you prefer to receive feedback?

Students selected any of 5 responses (as many as applicable).

Q5: How much time do you feel is reasonable to demonstrate your application of the feedback provided by your educator?

Students selected any of 4 responses (as many as applicable).

Q6: What do you see as your role in receiving feedback as a student?

• Students provided free responses to this question; the following themes were identified, and each response was coded with the applicable theme(s)
• 73 students provided responses
• Students should demonstrate implementation of feedback and carry-over between sessions
• 40 responses
• Students should be open to feedback and accept it, not taking it personally
• 25 responses
• Feedback as a learning opportunity for the student
• 24 responses
• Students should critically think about the feedback they are receiving and ask questions about their feedback
• 18 responses
• Feedback is validation for the student
• 3 responses

Q7: What excites you the most regarding fieldwork?

• Students provided free responses to this question; the following themes were identified, and each response was coded with the applicable theme(s)
• 74 students provided responses
• Getting hands-on experience
• 39 responses
• Learning in a new environment/learning new skills and new information unique to fieldwork
• 34 responses
• Professional development (e.g., working with other professionals, professional milestones)
• 25 responses
• Getting feedback as part of their education
• 5 responses

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Q8: What intimidates you the most regarding fieldwork?

• Students provided free responses to this question; the following themes were identified, and each response was coded with the applicable theme(s)
• Not knowing
• 16 responses
• Adapting while working – being able to change and adapt to things as they come, thinking on the spot, answering questions on the spot
• 16 responses
• Poor communication: communication problems regarding feedback, expectations
• 15 responses
• Not feeling prepared for this fieldwork
• 12 responses
• Making mistakes, particularly with patients
• 9 responses
• Learning new things, working in new environments
• 10 responses
• Not being able to work/making very little money
• 3 responses

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Q9: Do you anticipate working during level II fieldwork?

• 45 students stated they anticipate working during level II fieldwork
• Of these students,
• Full-time (30-40): 1 student
• Part-time (15-29): 11 students
• Minimum (less than 15): 29 students
• The remaining students were not sure exactly how many hours they would work (4 students)
• Statements from these students included:
• “as much as possible while still being sane”
• “as many as my schedule allows me to work”
• 4 students that indicated no did state they may work if possible:
• “If I can find something at night, I would be willing to work 10-15 hrs a week”
• “I would do 8 hours if I had FW 4 days a week and not 5”

Importance of Feedback

• Essential for learning
• Provided to correct, reinforce, or influence the learner’s knowledge and/or performance
• Timely feedback is reported as the single most important part of learning
• Characteristics that impact the outcome of feedback process
• Specificity
• Timing
• Tone
• Relation to education goals

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Effective Feedback

• Sample questions that can help the feedback process:
• Is there a better way for me to provide you feedback on your moving or handling skills?
• What else would be helpful to your learning about how to effectively use this tool?

Effective Feedback

Develop a Feedback Plan

At the beginning of the fieldwork experience, it is helpful to:

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Develop a Feedback Plan: Example

Feedback Constructs

Models of Feedback

Sandwich & Ask, Respond, Tell

Sandwich Model

• Embedding negative feedback in between two layers of positive feedback
• Create a balance between negative and positive feedback
• Not overwhelm the student with negative feedback
• Subsequently reject the feedback
• Utilizing constructive feedback vs. negative feedback
• Negative - implies there is a lack of performance
• Constructive - leaves room for growth

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Ask, Respond, Tell (ART) Model

• More appropriate for Level II Fieldwork
• Can begin the experience using the Sandwich Model, but transition to ART model
• Student plays a more active role- it is bidirectional
• Also referred to as the Ask-Tell-Ask model
• Steps
• Ask the student what they think they did well
• Reinforce and provide a new complement
• Tell the student an area to grow
• Ask the student where they think they can grow

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Pendleton

• The instructor facilitates a structured bidirectional model dialogue; the learner is asked to describe what went well and what needs to be improved (in that order)
• Help the learner engage in self reflection and analysis of their learning and understanding
• FWE asks guided questions - self-assess a specific aspect of learning
• A challenge with this type of feedback is asking too vague of questions
• Student may not understand specific target the question was designed for
• Questions should facilitate clinical reasoning and allow the student to reflect on their performance

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One Minute Preceptor�

Feedback Considerations

Be truthful and honest

Keep it short and sweet

Make feedback actionable

Be non-threatening and non-judgmental

Give feedback in real-time

Show passion and genuine concern for the learner’s growth

Model Practice Activity 1

• It is week 3 for your Level II fieldwork student. You, the FWE, want to give feedback regarding their documentation skills, since your student is unable to finish assigned documentation by the end of the day. The notes are very detailed; however, many specifics are not necessary. You want to give guidance to improve your student’s time management skills and go over the pertinent information to be included.
• Which feedback exchange model discussed would you select to use (Sandwich Model, ART, Pendleton Approach), and why?

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Model Practice Activity 2

• Let’s apply the One-Minute Preceptor Model:
• Remember the five steps:
• Get a commitment
• Probe for supporting evidence
• Reinforce what was done well
• Give guidance about errors and omissions
• Teach a general principle
• CASE: TEACHING FUNCTIONAL TRANSFER TECHNIQUES
• FWE: “I have had multiple Level I students whose transfer techniques were ineffective. The students were not using good body mechanics. I wanted to help them learn to evaluate their own techniques so that in the future they could effectively assess their own performance. I knew the academic curriculum well enough to know that therapist body mechanics during transfer had been covered in classes, so I used that information to set up the feedback session for each of these students. In the case of one particular student, I knew that they did better when they were able to observe a skill before trying it themself.”
• Using the five steps of the One-Minute Preceptor Model, develop your side of the feedback session between you and the student.

References

• DeIuliis, E. D. & Hanson, D. (Eds.). (2023). Fieldwork educator’s guide to level II fieldwork. SLACK Incorporated.
• Hanson, D. & DeIuliis, E. D. (Eds.) (2023). Fieldwork educator’s guide to level I fieldwork. SLACK Incorporated.