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Campus Spotlight: Dental College of Georgia at Augusta University

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By Debra Werrlein

Dental College at Augusta LogoWhen 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?

When Dr. Mitchell investigated further, she found that many professors had noticed a change in students in recent years. Many now seemed “fragile” and unable to handle criticism.

This 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.

“Dental 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.”

Add that research also suggests today’s young people demonstrate higher levels of overconfidence, entitlement and anxiety, and the 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.”

Her solution 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.

The objectives of the session are three-fold:

  • Introduce the concept of deliberate practice.
  • Show that feedback is part of every individual’s professional development.
  • Increase awareness of emotions around feedback.

The seminar 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.”

Students are 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.”

Through these 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.

In their 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 themselves.”

The origami 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.”

To conclude 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.”

The seminar 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.

Of course, 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.

"Will one 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.”

Thank you for sharing your thoughtful and applicable insight!
Posted by: Janet Woldt at 2/28/2017 5:15 PM

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