From value to valued: a qualitative longitudinal study of international medical students’ feedback perceptions and applications in learning communication skills

Abstract Introduction This study explores how first-year international medical students’ perceptions of feedback evolve as they develop communication skills through repeated simulated patient consultations (SPCs). Understanding how learners come to value different feedback sources may help educators design feedback processes that are better aligned with learners ‘changing needs in communication learning. Methods We conducted a longitudinal qualitative study over 36 weeks with 10 first-year international medical students. Data were collected through semi-structured interviews with structured ranking prompts and through observation notes from tutorial discussions. Results Students’ perceived values of feedback changed across the four SPCs. Simulated patient feedback was valued most highly early in the sequence, peer feedback became more prominent in the middle sessions, and tutorial discussions were valued most highly later in the course. Interview and observation data identified four themes that help explain these shifts: Navigating Stress: The Dynamics of Feedback Utilization and Learning Choices; Adapting to the Challenge: How Much to Prepare and What to Do Spontaneously; Reflections to Automate Actions and Consultation Structure; and Dealing with the Bottleneck: Emotions Are Heavy and Silent. Discussion The findings suggest that the perceived value of feedback in repeated simulated patient consultations is developmental rather than fixed. The usefulness of different feedback sources appeared to depend on the changing fit between learner readiness, consultation demands, and feedback source. These findings imply that feedback processes in communication education should be designed in ways that recognize the changing functions of multiple feedback sources over time.