Development and preliminary psychometric properties of the Care Experience Feedback Improvement Tool (CEFIT).

Objective To develop a structurally valid and reliable, yet brief measure of patient experience of hospital quality of care, the Care Experience Feedback Improvement Tool (CEFIT). Also, to examine aspects of utility of CEFIT. Background Measuring quality improvement at the clinical interface has become a necessary component of healthcare measurement and improvement plans, but the effectiveness of measuring such complexity is dependent on the purpose and utility of the instrument used. Methods CEFIT was designed from a theoretical model, derived from the literature and a content validity index (CVI) procedure. A telephone population surveyed 802 eligible participants (healthcare experience within the previous 12 months) to complete CEFIT. Internal consistency reliability was tested using Cronbach's α. Principal component analysis was conducted to examine the factor structure and determine structural validity. Quality criteria were applied to judge aspects of utility. Results CVI found a statistically significant proportion of agreement between patient and practitioner experts for CEFIT construction. 802 eligible participants answered the CEFIT questions. Cronbach's α coefficient for internal consistency indicated high reliability (0.78). Interitem (question) total correlations (0.28–0.73) were used to establish the final instrument. Principal component analysis identified one factor accounting for 57.3% variance. Quality critique rated CEFIT as fair for content validity, excellent for structural validity, good for cost, poor for acceptability and good for educational impact. Conclusions CEFIT offers a brief yet structurally sound measure of patient experience of quality of care. The briefness of the 5-item instrument arguably offers high utility in practice. Further studies are needed to explore the utility of CEFIT to provide a robust basis for feedback to local clinical teams and drive quality improvement in the provision of care experience for patients. Further development of aspects of utility is also required.

Public feedback - but personal feedforward?

Academic feedback is taken here as the reporting to student writers of the strengths and weaknesses of their submitted draft work, while academic feedforward refers to constructive advice regarding possible strengthening of students’ next work. Both originate from a tutor’s initial judgement of a student’s work. Feedback and feedforward on work showing need for improvement are problematic in a Confucian Heritage Culture. Even gently constructive advice within a programme seeking evidence for assessment of critical thinking may lead to perception of hurtful criticism by Taiwanese students. Some could withdraw from class activity accordingly. So the writers adjusted their response style. They now choose between different approaches featuring tutorial feedback or feedforward, depending on the standard of work being judged. When individual postings feature poor critical thinking, the writers opt for private messages concentrating on constructive feedforward. For better postings, they provide positive feedback with reasons for their judgements, and summarise to the class these exemplars of generic strengths in critical thinking. They also offer private prompting when they see scope for further enrichment of an able student’s critical thinking. This might also be a useful practice when tutoring solely in the West. (192 words) Keywords: Confucian Heritage Culture, public feedback, private feedforward, assessment

Feedback Unbound: from master to usher.

A major theme of this book is that feedback should encourage dialogue; between students and lecturers, amongst peers and individually, as a form of self-critique and reflection. Here we endorse that theme but also propose an understanding of dialogue that goes beyond simple exchang or the presence of two or more voices. Inspired by Freire’s (1996) critical pedagogy we seek to make a link between the social nature of learning, the social nature of dialogue and the role of feedback as dialogue in a broader transformative learning process, and not merely as an adjunct to assessment.

Marking and providing feedback face-to-face: staff and student perspectives.

The setting, marking and providing feedback on assessments forms an important part of a tutor’s role. Studies into the use of feedback and how it is interpreted by students indicate a mismatch between what students are looking for and what tutors think they are giving. Tutors comment that students are more interested in the mark than the feedback, and yet students indicate that they do not get enough feedback, or that it is not useful. This study investigates student and staff perceptions of the linking of marking and feedback in face-to-face sessions. A cohort of year one university students were given the option of receiving either written feedback or a 15 minute meeting with one of their tutors to have their essay marked with them. Forty nine students chose face-to-face marking, the remaining 35 students received written feedback. Focus groups were used to investigate the student experience. Staff members were also asked to reflect on the process. Students and staff found the experience of face-to-face marking beneficial and positive. Both felt that the time spent together allowed for a feedback dialogue about the piece of work, and that staff could explain and justify why marks were given.