Making sense of feedback experiences: a multi-school study of medical students' narratives.

CONTEXT: Until recently, the perspective of students in the feedback process has been ignored, with strategies for improvement focusing on the tutor and feedback delivery. We employed an original narrative interviewing approach to explore how medical students make sense of their experiences of feedback.

METHODS: A qualitative design was adopted employing three individual and 10 group interviews to elicit narratives of feedback experiences from 53 medical students at three 5-year undergraduate programmes in the UK during 2011. Thematic analysis was undertaken of students' understandings of feedback and of their narratives of positive and negative experiences of feedback at medical school. In addition, thematic and discourse analysis of the linguistic and paralinguistic features of talk within the narratives was conducted.

RESULTS: Students typically constructed feedback as a monologic process that happened 'to' them rather than 'with' them. They shared 352 distinct narratives of feedback experiences, which were rich in linguistic and paralinguistic features of talk. Through the analysis of the interplay between the 'whats' and 'hows' of student talk, i.e. emotion, pronominal and metaphoric talk and laughter, we were able to understand how students find meaning in their experiences. Students used laughter as a coping strategy, emotion talk as a means to convince the audience of the impact of feedback, pronominal and metaphoric talk to describe their relationship (often adversarial) with their feedback providers and to communicate feelings that they might otherwise struggle to articulate.

CONCLUSIONS: This research extends current feedback literature by focusing on medical students' lived experiences of feedback and their emotional impact through narrative. We go on to discuss the educational implications of our findings and to make recommendations for improvement of the feedback process for students, tutors and for institutions.