Neel Sharma: We need to improve feedback to medical students

The other day I made a point of observing the number of people walking whilst using their mobile phones. I am sure we have all made a similar observation of people staring down at their phones. The vast extent of the problem has even been characterised clinically as “text neck.” I recall the days of my teens when mobile phones either didn’t exist or were a luxury. I was allowed to use my parents’ mobile on a Saturday evening when meeting friends to watch a film or go for dinner. And now it seems that if we don’t exchange instant messages with each other or send several Emojis’ a day we are out of touch

It is not just with materialistic items where we have become spoilt for choice. From a health perspective, fast food is abundant. It seems that walking to work nowadays requires holding your phone in one hand and the latest sugar excess latte in the other. I have only ever lived in cities and so maybe my personal observation of such excess living is biased. But there is no escaping globalisation. During my current stint in Asia, even during my treks to less developed parts of the world there is always a McDonalds, KFC, or Starbucks glaring round the corner. We are certainly spoilt for choice. Yet this excessive lifestyle has not been associated with positive outcomes.

Drawing parallels to medical education it seems we are observing a similar trend. Currently students are spoilt for choice in terms of teaching methods from didactic lectures, to problem based and team based learning. The advances in technology have allowed for online modules, ease of access to evidence base, high fidelity simulation, virtual simulation, flipped classrooms, MOOCs, and so on. There is certainly a vast array of teaching methods at present. Yet despite all this, medical schools don’t seem to be scoring highly in the particular domain of teacher feedback to students.

We know that an over saturated market exists as thus described. Yet an over saturated market does not necessarily lead to better outcomes. Rather than flooding the educational domain with teaching strategy x, y, and z, why not focus on the strategies that can enhance feedback, the one domain students are less satisfied with. Even though we as educators are pushing forward strategies in the hope to enhance feedback such as flipped classrooms, simulation, and team based learning, the biggest gap we all know lies in post assessment feedback. It simply doesn’t exist. Without students knowing where they went wrong there is simply no hope of improving performance before the time they practice. Why are we as educators turning a blind eye to the obvious?

Neel Sharma graduated from the University of Manchester and did his internal medicine training at The Royal London Hospital and Guy’s and St Thomas’ NHS Foundation Trust. Currently he is a gastroenterology trainee based in Singapore.

Competing interests: None declared.