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

Intensive care survivors’ experiences of ward-based care: Meleis’ theory of nursing transitions and role development among critical care outreach services.

Aims and objectives. To explore the psychosocial needs of patients discharged from intensive care, the extent to which they are captured using existing theory on transitions in care and the potential role development of critical care outreach, follow-up and liaison services. Background. Intensive care patients are at an increased risk of adverse events, deterioration or death following ward transfer. Nurse-led critical care outreach, follow-up or liaison services have been adopted internationally to prevent these potentially avoidable sequelae. The need to provide patients with psychosocial support during the transition to ward-based care has also been identified, but the evidence base for role development is currently limited. Design and methods. Twenty participants were invited to discuss their experiences of ward-based care as part of a broader study on recovery following prolonged critical illness. Psychosocial distress was a prominent feature of their accounts, prompting secondary data analysis using Meleis et al.’s mid-range theory on experiencing transitions. Results. Participants described a sense of disconnection in relation to profound debilitation and dependency and were often distressed by a perceived lack of understanding, indifference or insensitivity among ward staff to their basic care needs. Negotiating the transition between dependence and independence was identified as a significant source of distress following ward transfer. Participants varied in the extent to which they were able to express their needs and negotiate recovery within professionally mediated boundaries. Conclusion. These data provide new insights into the putative origins of the psychosocial distress that patients experience following ward transfer. Relevance to clinical practice. Meleis et al.’s work has resonance in terms of explicating intensive care patients’ experiences of psychosocial distress throughout the transition to general ward–based care, such that the future role development of critical care outreach, follow-up and liaison services may be more theoretically informed.