Study 1: Evolving Perceived Value of Feedback: Impact on Medical Communication during Simulated Patient Consultations

<B>Summary of the Study</B><BR><BR>
This study explored how first-year international medical students’ perceptions of different feedback sources changed over the course of <B>four simulated patient consultations (SPCs)</B> during a <B>36-week qualitative study</B>. The aim was to understand how the value of feedback evolves as communication skills develop.<BR>
• <B>Design:</B> Qualitative longitudinal design.<BR>
• <B>Participants</B>: 10 international first-year medical students (1 male, 9 female; mean age 21).<BR>
• <B>Procedure:</B><BR>
o Students completed four SPCs (each followed by feedback and a tutorial discussion).<BR>
o Data collected via:<BR>
 <I>Closed questions</I> on ranking feedback sources (student buddies, simulated patients, video annotations, tutorial discussions).<BR>
 <I>Observation notes</I> from SPCs and tutorials.<BR>
 <I>Semi-structured interviews</I> (documenting emotions, reactions, and reflections).<BR>
o Data analysis: Inductive thematic analysis following Braun & Clarke, triangulated with observation notes.<BR>
<B>Key Findings:</B><BR>
1. <B>Ranking of feedback sources over four SPCs:</B><BR>
o SPC1: Simulated patient feedback ranked highest.<BR>
o SPC2: Student-buddy feedback most valued.<BR>
o SPC3: Student-buddy feedback still top, but tutorial discussions gained importance.<BR>
o SPC4: Tutorial discussions became the most trusted source of feedback.<BR>
2. <B>Four explanatory themes for evolving feedback preferences:</B><BR>
o <I>Struggling with stress</I>– Early SPCs were stressful; peer feedback helped with coping strategies.<BR>
o <I>Adapting to the challenge</I> – With experience, students shifted from patient-centered feedback to peer and tutorial insights.<BR>
o <I>Enhancing learning efficiency</I> – Tutorial discussions reduced extraneous cognitive load by clarifying procedures and prioritizing focus.<BR>
o <I>Listening to the full story</I> – Over time, students emphasized empathy, authenticity, and hearing the patient’s narrative.<BR>
3. <B>Discussion & Implications:</B><BR>
o Early reliance on simulated patient feedback reflects novice learners’ need for clear, immediate, patient-centered advice.<BR>
o Growth in valuing peer and tutorial feedback reflects <B>maturation, collaboration, and reflective practice</B>.<BR>
o Highlights the need for <B>adaptive feedback mechanisms</B> tailored to students’ developmental stage in communication skills learning.<BR><BR>