Meaningful feedback in medical examinations

The Australian Council for Educational Research (ACER) has for several years supported the Royal Australian and New Zealand College of Radiologists (RANZCR) to ensure its examinations align with the principles of high-quality assessment.

In an article published in the December 2021 edition of Inside News, the quarterly publication of RANZCR, ACER Principal Research Fellow Dr Jacob Pearce outlines best practice on assessment feedback in medical education and the implications for clinical radiology examinations.

‘It is commonplace to hear different views on feedback in medical education,’ Dr Pearce writes. ‘Trainees argue that they don’t get enough and what they do get is not useful. Trainers argue that they give large volumes of feedback but trainees do not necessarily engage with it in the right way.’

Dr Pearce explains that the academic literature on assessment and feedback in higher education has shifted in recent times away from conceptualising feedback as a justification or explanation of marks, to a focus on feedback primarily being about the ability to impact and enhance future learning.

‘Two major components of feedback are the quality of the information or data that is presented to the trainee, and the requirement for active engagement by the trainee. One without the other results in a mismatch, and an inability for meaningful feedback to occur,’ Dr Pearce writes.

Dr Pearce notes this conception of feedback is in tension with many of the elements of feedback that typically arise from higher-stakes assessments like examinations.

‘Information that is necessarily static, such as results, grades, ratings and even comments from examiners, cannot in and of itself engage the learner,’ Dr Pearce writes. ‘This does not, however, imply that static feedback provides no value.’

According to Dr Pearce, it is important to recognise the role of this type of feedback and ensure that it is used in a meaningful and effective way, such as identifying areas of strength and weakness in an examination report – even if the trainee passes the examination.

In consultation with ACER, RANZCR is exploring different options for communicating candidate results, including scores by item format and performance by topic area. This will provide trainees with more nuanced information with which to target their learning going forward.

‘Examination reports can provide detailed and meaningful information to the trainee, but it is how the trainee actively engages with this information that is crucial to the process of feedback,’ Dr Pearce writes.

Read the full article:
‘Meaningful Feedback in Medical Education: Best practice and implications for clinical radiology examinations’ by Jacob Pearce, Inside News, Vol 18, No. 1, December 2021 (Royal Australian and New Zealand College of Radiologists).