Developing a culturally sensitive formative feedback model for medical education in an ethnically diverse environment: a Sri Lankan case study

Learner-centered feedback is one of the most powerful influences in learning and achievement. However specific literature on feedback for culturally diverse environments, such as Sri Lanka is lacking. By addressing this problem, I aimed to enhance learning and teaching in medical schools. The objective was to explore and develop a culturally sensitive feedback guidance model for Medical Education. This qualitative, ethnographic, case study of the ethnically diverse Eastern University, Sri Lanka (EUSL) was emergent in design. Staff and students of EUSL represent predominantly three different ethnicities, Sinhala, Tamil and Muslim. Piloting highlighted the dominance of deficit thinking, which was mediated by the introduction of an Appreciative Inquiry framework. Data gathering utilised observation of learning conversations and semi structured interviews with three types of stakeholders, students, faculty and policy makers. Continuous ongoing analysis and iterative literature searching illuminated the value of an anthropological perspective to define “culture” and contextual power dynamics. Planned thematic analysis was usefully supplemented by discourse analysis in order to reduce uncritical imposition of western concepts. Findings identified under-problematization of feedback practices, unaddressed cultural and historical complexities and evidence of espoused claims, alongside interest and willingness to develop a model to address the post-colonial challenges from overly simplistic hegemonic “west is best” assumptions. Non-WEIRD (Westernised, Educated, Industrialised, Rich and Democratic) countries e.g. Sri Lanka can benefit from WEIRD evidence-based theories such as dialogic feedback and learner transitions best when informed by and adapted to local cultural practices and knowledge. A key outcome is a blueprint for co-adaptation of western theories and co-construction of locally effective Formative Assessment mechanisms and feedback practices. The cSEEFAR (culturally Sensitive, Effective and Efficient, Formative Assessment Relationships) blueprint model is a comma rather than a full stop, an opportunity to contribute to global understandings and facilitate increased praxis between theorized accounts of formative assessment and sensitive best practice for Sri Lanka.