By Debra Werrlein
When student course evaluations
at the Dental College of Georgia at Augusta University (DCG at
Augusta) regularly showed that students felt
personally attacked by professors’ comments, Jan
Mitchell, D.D.S., M.Ed., wondered what was going on. “I was in those classrooms,”
she says, “and I knew that the comments were not meant to be hurtful. We're
talking about routine, corrective feedback here.”
So why did
students feel so threatened?
Mitchell investigated further, she found that many professors had noticed a
change in students in recent years. Many now seemed “fragile” and unable to
phenomenon is documented in research, where faculty-related issues such as
inconsistent feedback and criticism that is perceived to be unjustified are
found to be high causes of stress for dental students, second only to the
pressure to perform academically.
students arrive on campus with a strong academic record,” says Dr. Mitchell, “so
they’re not used to criticism.” Also, as undergraduates, they typically major
in the sciences where academic experiences often involve big lecture halls and
solitary study time. Undergraduates in these environments are used to taking
tests and receiving grades anonymously. Dental school can be a rude awakening, says
Dr. Mitchell. “Suddenly we ask them to receive feedback face-to-face. That’s a
change that can feel threatening to some.”
research also suggests today’s young people demonstrate higher levels of
overconfidence, entitlement and anxiety,
possibilities for misunderstanding grow even greater, explains Dr. Mitchell.
Despite the gap
between student and professor expectations regarding feedback, Dr. Mitchell felt
strongly that professors at DCG at Augusta should not curtail these
interactions. She believes that correction is critical to deliberate practice—the
process of refining a skill while receiving expert feedback. “Practice without feedback,”
Dr. Mitchell says, “is wasted.”
to the students’ discomfort: better prepare them to receive constructive
criticism. In the absence of existing research on how to deliver this kind of
information, Dr. Mitchell collaborated with Ralph A. Gillies, Ph.D., a
psychologist from the Medical College of Georgia at Augusta University, to
create DCG at Augusta’s Orientation to Feedback seminar, a half-day course delivered
to new first-year students during their orientation week.
of the session are three-fold:
- Introduce the concept of deliberate
- Show that feedback is part of every
individual’s professional development.
- Increase awareness of emotions around
includes independent, interactive and group work designed to highlight the
positive aspects of receiving feedback while also helping students explore
their feelings about receiving correction. To start, a preliminary reading of
the article “Feedback in Clinical Medical Education” by Jack Ende, M.D., and a short 20-minute lecture
familiarize students with the concepts of corrective feedback and deliberate
practice. These activities emphasize that all students must practice their
skills and that no one has “the golden hands.”
then divided into small groups where they are asked to discuss the ways
receiving face-to-face feedback can feel different from receiving a letter
grade. They also read the abstract of an article about how effective feedback
is less popular than praise among medical students. “The reading often brings
wry laughter from students,” says Dr. Mitchell, adding, “but then they say it
isn’t them; they would want the feedback.”
activities, explains Dr. Mitchell, students begin to develop a self-awareness
of how they might react to correction. They also gain some perspective on how
feedback, more than praise, can help them improve their practice.
groups, students are also asked to follow directions to create an origami crown.
They then use a rubric to assess their performance and that of their peers.
This exercise helps students see that practice with rubrics will develop the
internal judgment needed to practice independently,” says Dr. Mitchell. “If
they can articulate their own strengths and weaknesses first, then when we come
around, they’ve already gone through the first steps. They’ve prepared
project also teaches the value of peer evaluation. This, Dr. Mitchell explains,
is a big step for many students who feel entitled to privacy regarding their
performance. “Students need to get over the idea that they deserve, or should
even desire, privacy in practice. As medical professionals, they must be
willing to seek and receive feedback from their colleagues without feeling
stressed about it, and our peer-review exercises are the beginning of their
professional responsibility for peer review.”
the seminar, students read a list of ideas about feedback, such as “criticism
is hard to take” and “seeking help shows weakness,” then rate how likely they
are to relate to each one. Rating these statements, says Dr. Mitchell, “helps
students hone in on the ways they might feel challenged by feedback.”
reduces stress by giving students a vocabulary through which to discuss their
feelings about feedback, whether they feel threatened by it or constantly seek
it out for reassurance. DCG at Augusta has run the feedback seminar for four
years, and faculty consider it a huge success. Students identify it as their
favorite part of orientation, and fewer students visit the Dean for Students to
report they’ve “come to their snapping point,” Dr. Mitchell says.
Faculty have also
noted a change in student attitudes and demeanor. They no longer appear defensive
and irritable as they have in years past. This change is also reflected in course
evaluations, where far fewer students report taking classroom correction personally.
student stress in any health professions program is a complicated thing, and Dr.
Mitchell understands the limitations of what she and her colleagues are doing
at DCG at Augusta.
half-day seminar remove the stress of dental school for these students? No,”
she concludes, “but every little bit helps, and I also know we aren’t hurting
anything. It’s like flossing your teeth, so let’s go for it.”