In this weeks’ blog, Karen Patrick, Registered Children’s Nurse, Lecturer in Nursing (Child), MSc Health Studies, FHEA, reflects on her experiences talking to students about what is important to them about effective feedback. @karen_pattrick

All feedback given within the practice environment should be positive and constructive  Nursing students need opportunities to seek clarity about areas for development in a learning environment that is supportive, and with trusting professional relationships between assessors, supervisors and student.

The Nursing and Midwifery Council¹ states nurses should be able to provide honest, accurate feedback to colleagues including nursing students to assist them to develop their professional competence and confidence. It is recognised that constructive and timely feedback enhances the student experience and is linked to achievement and increased confidence^2,3. However, this is complex, requiring compassion, insight and a respectful student assessor relationship⁴.   The following identified areas are based on my own work with students and narratives of their experience. Students have highlighted examples of poorly delivered feedback or lack of constructive feedback. This negatively impacts the learning journey and can prevent student nurses from reaching their full potential.

Students need to recognise their own learning and seek feedback: 

Students will not always have the knowledge, skills and insight to know when to seek constructive feedback and likely will be reliant on the practice or supervisors to identify opportunities.  When feedback was sought or offered by the assessor or supervisor, feedback was not always specific to a situation, clearly articulated or presented in terms of proficiencies or behaviours. This lack of clarity often creating more confusion³.  Students stated this creates unnecessary barriers to learning which needed to be overcome and feels like they need to “jump through hoops” to learn.

The timing of feedback is important:

Student nurses expect and welcome constructive feedback¹ and this needs to be provided at regular intervals throughout the placement.  Student nurses perceived that even at mid-point interviews, this was often too late to address any concerns an assessor or supervisor may have.  However, practice assessors and supervisors may worry that providing constructive feedback may affect the relationship between the nurse and the student.  One student’s opinion was “I do not need them to be my friend, I need them to teach me!”

The location or where the constructive feedback was provided can have a negative impact:

Students stated that a common location to provide this in the ward.  Repeatedly receiving constructive feedback in an area where the student is also required to perform assessed clinical activities, such as medication calculations and preparation can create a negative association when entering the room. This can heighten student anxieties and may impact their confidence and the ability to demonstrate competence in this area.

These three key areas are highlighted by the students I talk to and provide examples of the importance of constructive feedback. They offer a unique insight for assessors and supervisors enhancing the provision of supportive placement environments. This enhances the learning journey and supports the development, professional competence and confidence of student nurses.

References

1. Nursing and Midwifery Council (2018) The Code. Available at https://www.nmc.org.uk/standards/code/read-the-code-online/
2. Plakht, Y., Shiyovich, A., Nusbaum, L. & Raizer, H. (2013) The association of positive and negative feedback with clinical performance, self-evaluation and practice contribution of nursing students.  Nurse education today,  33 (10) 1264-1268.
3. Sultan, B., & Gideon, V. (2021). Bachelor of science in nursing students’ perceptions regarding educator feedback.Journal of Nursing Education, 60 (10), 577-581.
4. Adamson E, King L, Foy L, McLeod M, Traynor J, Watson W, Gray M. (2018). Feedback in clinical practice: Enhancing the students’ experience through action research. Nurse Education in Practice. 31 48-53.