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Background This study aimed to investigate the various models of student representation in curriculum development across medical schools in the United States, based on the participatory governance theory. Recognizing the critical role of student feedback in enhancing medical education, the work sought to assess the diversity of student representation models, identify key elements that contribute to effective student involvement, and evaluate the potential impact on curriculum outcomes. Methods An initial list of 166 allopathic MD schools was curated from the AAMC Medical Schools Admission Requirements website. Schools were selected based on the presence of information about student representation in curriculum design. This selection was refined through a Google search using specific search terms related to student representation, followed by an evaluation based on the amount and relevance of available information on each school’s website. The methodology involved a detailed examination of the websites for selected schools, focusing on the structure and organization of student involvement in curriculum development. Results Of the initial 166 medical schools, 49 (29.7%) had publicly available information on student involvement in curriculum development. These schools were categorized into three main models of student representation: direct representation, feedback-driven, and hybrid models. The analysis revealed significant diversity in how student representation is implemented, with each model exhibiting unique strengths and limitations. Direct representation models were found to facilitate substantive student roles in decision-making, feedback-driven models excelled in rapidly integrating student feedback into curricular adjustments, and hybrid models combined aspects of both to provide a comprehensive approach to student involvement. Conclusions There is no one-size-fits-all model for student representation in medical education. However, the hybrid model shows promise for its balanced approach to integrating student perspectives into curriculum development. Continuous evaluation and refinement of student representation models are essential for ensuring that medical education remains responsive to the needs of students and the evolving landscape of the medical field. This work underscores the importance of student feedback in medical education and advocates for further studies to quantify the impact of different models of student representation on educational outcomes and professional success.

Background Clinical decision-making (CDM) refers to physicians’ ability to gather, evaluate, and interpret relevant diagnostic information. An integral component of CDM is the medical history conversation, traditionally practiced on real or simulated patients. In this study, we explored the potential of using Large Language Models (LLM) to simulate patient-doctor interactions and provide structured feedback. Methods We developed AI prompts to simulate patients with different symptoms, engaging in realistic medical history conversations. In our double-blind randomized design, the control group participated in simulated medical history conversations with AI patients (control group), while the intervention group, in addition to simulated conversations, also received AI-generated feedback on their performances (feedback group). We examined the influence of feedback based on their CDM performance, which was evaluated by two raters (ICC = 0.924) using the Clinical Reasoning Indicator – History Taking Inventory (CRI-HTI). The data was analyzed using an ANOVA for repeated measures. Results Our final sample included 21 medical students (age mean = 22.10 years, semester mean = 4, 14 females). At baseline, the feedback group (mean = 3.28 ± 0.09 [standard deviation]) and the control group (3.21 ± 0.08) achieved similar CRI-HTI scores, indicating successful randomization. After only four training sessions, the feedback group (3.60 ± 0.13) outperformed the control group (3.02 ± 0.12), F (1,18) = 4.44, p  = .049 with a strong effect size, partial η 2  = 0.198. Specifically, the feedback group showed improvements in the subdomains of CDM of creating context ( p  = .046) and securing information ( p  = .018), while their ability to focus questions did not improve significantly ( p  = .265). Conclusion The results suggest that AI-simulated medical history conversations can support CDM training, especially when combined with structured feedback. Such training format may serve as a cost-effective supplement to existing training methods, better preparing students for real medical history conversations.

Research emphasises the need for mutual understanding of feedback purpose, i.e. staff and student feedback literacy. Interprofessional practice is crucial to effective patient care. While undergraduates increasingly learn and are assessed together, less is known of their shared or differing experiences of feedback. This study aimed to explore how students and faculty in medicine and pharmacy perceive an evidence-informed draft feedback strategy. Methods  A student partnership approach was taken to this cross-faculty study. Focus groups of faculty from the Schools of Medicine (SOM) and Pharmacy (SOP) were undertaken by a faculty researcher. A SOP student facilitated student focus groups across both schools. Data was thematically analysed using template analysis by staff and students from both schools. Results  Three over-arching themes are described: feedback goals, environment and design. Heterogeneous conceptualisations make it difficult for faculty to signpost and students to recognise feedback. Feedback goals and operationalisation contrasted in junior and senior years. Junior students were frustrated by “overly nice”, generic feedback; senior students baulked at a “roasting culture”, more marked for medical students. Conclusion  Despite an expanse of research-informed theory, processes in practice are unsupportive of feedback literacy. Even within programmes, context differs and must be considered when embedding a positive whole-programme feedback culture. Clinical Trial number  Not applicable.

Background Peer evaluation can provide valuable feedback to medical students, and increase student confidence and quality of work. The objective of this systematic review was to examine the utilization, effectiveness, and quality of peer feedback during collaborative learning in medical education. Methods The PRISMA statement for reporting in systematic reviews and meta-analysis was used to guide the process of conducting the systematic review. Evaluation of level of evidence (Colthart) and types of outcomes (Kirkpatrick) were used. Two main authors reviewed articles with a third deciding on conflicting results. Results The final review included 31 studies. Problem-based learning and team-based learning were the most common collaborative learning settings. Eleven studies reported that students received instruction on how to provide appropriate peer feedback. No studies provided descriptions on whether or not the quality of feedback was evaluated by faculty. Seventeen studies evaluated the effect of peer feedback on professionalism; 12 of those studies evaluated its effectiveness for assessing professionalism and eight evaluated the use of peer feedback for professional behavior development. Ten studies examined the effect of peer feedback on student learning. Six studies examined the role of peer feedback on team dynamics. Conclusions This systematic review indicates that peer feedback in a collaborative learning environment may be a reliable assessment for professionalism and may aid in the development of professional behavior. The review suggests implications for further research on the impact of peer feedback, including the effectiveness of providing instruction on how to provide appropriate peer feedback.

Background Feedback is crucial in medical education for developing communication skills and fostering comprehensive learning. Despite its importance, medical students often face challenges in effectively leveraging feedback. This study investigates how students perceive and make sense of internal and external feedback in a 2nd language (L2) medical Dutch course. Methods Sixteen third-year international medical students (mean age = 23) participated in a medical Dutch course that included six structured sessions. Each session encompassed a briefing, simulated patient consultations (SPCs), and a debriefing. The curriculum integrated internal feedback from self-reflections and external feedback from peers, teachers, and simulated patients. Data were gathered through a students’ feedback perception survey and semi-structured interviews and analyzed via inductive thematic analysis. Results Survey data indicated a trend where the preference, satisfaction, and trust in external feedback were higher than those for internal feedback. However, both types of feedback were regarded as equally effective in facilitating learning progress. Through thematic analysis, we identified five crucial themes that show how students perceive and make sense of various forms of feedback: proactive engagement with feedback, critically analyzing and utilizing the exchange in dialogues and discussions, self-reflection and progress tracking, value from diverse perspectives, and moment-specific and actionable feedback. Conclusions This study emphasizes the vital roles of internal and external feedback in enhancing medical Dutch communication skills among medical students. Internal feedback encourages self-reflection and growth, essential for complex medical communications, while external feedback provides clear, specific and supportive guidance and experience from teachers, simulated patients and peers. These feedback mechanisms together improve students’ skills in medical Dutch communication, leading to better doctor-patient interactions. Future research should focus on adapting these feedback strategies across diverse educational settings to further support the development of medical L2 communication skills in global medical contexts.

Background Self-regulated learning is crucial for medical students because of the rigorous and dynamic nature of medical education. Previous studies have demonstrated the positive influence of teacher feedback on students’ self-regulated learning, particularly in basic education contexts. However, research exploring the mechanisms through which teacher feedback affects self-regulated learning among medical students in higher education contexts remains limited. This study aims to investigate the impact of teacher feedback on medical students’ self-regulated learning, with a focus on the mediation roles of teacher-student interaction and sense of school belonging. Methods Data were collected from a comprehensive survey of undergraduates at H University, a prestigious research-oriented institution in China. The sample included 6,546 medical students spanning five academic years (2014, 2016, 2018, 2021, and 2023). The Student Survey of Learning and Development questionnaire was utilized to collect data, and teacher feedback, teacher-student interaction, sense of school belonging, and self-regulated learning were chosen as variables in this study. Structural equation modeling was employed to analyze the relationships among these variables, with mediation and serial mediation effects assessed via the bootstrap method. Results Teacher feedback significantly predicted medical students’ self-regulated learning ( β  = 0.136, p  < 0.001). Teacher-student interaction ( β  = 0.377, p  < 0.001) and sense of school belonging ( β  = 0.325, p  < 0.001) were found to mediate the relationship between teacher feedback and self-regulated learning. The mediation effects, with effect sizes of 0.116 for teacher-student interaction and 0.045 for sense of school belonging, accounted for 37.91% and 14.71% of the total effect, respectively. Additionally, there was a serial mediation model between teacher feedback and self-regulated learning that had a value of 0.009, accounting for 2.94% of the total effect. Conclusion This study provides empirical evidence supporting the role of teacher feedback in promoting medical students’ self-regulated learning, with teacher-student interaction and sense of school belonging serving as important mediating factors. These findings have implications for designing effective educational interventions to cultivate self-regulated learners capable of adapting to the rapidly evolving landscape of medical knowledge and practice.

Feedback can improve students’ learning and performance on clinical placements, yet students are often dissatisfied with the process. Attempts to improve feedback frequently focus on faculty development programs without addressing learners’ capabilities to engage with feedback. For feedback to be effective, students need to understand its processes and to translate this into practice. Developing student feedback literacy may enhance feedback engagement and, therefore, learning outcomes. This qualitative interview study aimed to problematise student feedback literacy in the healthcare setting, from the learner’s perspective. Before commencing placements, 105 healthcare students at an Australian teaching hospital participated in a feedback literacy program. After their placements, 27 students engaged in semi-structured interviews to explore their feedback experiences. Informed by workplace learning theory, interview transcripts were analysed using the framework method of qualitative analysis. Students reported reframing feedback as a process they could initiate and engage in, rather one they were subjected to. When they took an intentional stance, students noted that feedback conversations generated plans for improvement which they were enacting. However, students had to work hard against orthodox feedback expectations and habits in healthcare. They privileged intraprofessional supervisor feedback over interprofessional practitioners, patients, or peers. Findings suggest that student engagement with feedback can be augmented with focussed retraining. However, further research examining the structural and cultural influences on students’ capacity to be active in workplace feedback is warranted.

Background Medical students benefit from direct observation of clinical performance and timely feedback from multiple sources. While self and peer feedback have been the focus of numerous research studies, how they influence feedback engagement and receptivity in medical students of varying achievement levels in the clinical skills laboratory setting remains relatively unexplored. Methods We conducted an exploratory qualitative study to investigate students’ engagement and receptivity to self and peer feedback across academic performance levels at a medical teaching institution. Data from five focus groups with third-year medical students( n  = 25) were thematically analysed. Results The ways in which low and high performing students engaged with self-assessment and peer feedback were divided into three categories: affective (or interpersonal), orientational, and transformational. Lower achievers believed they lacked the necessary skills to effectively engage in self and peer feedback interventions, but they agreed with higher achievers who recognized that peer feedback combined with prior knowledge of learning objectives allowed them to take ownership of monitoring their own development over time. Learners' emotional maturity in response to feedback ratings and feedback from activities testing clinical cognition had an impact on self-regulated learning. Conclusions Creating a trusting environment is critical for improving the acceptability of peer feedback. It is also critical to provide multiple opportunities for self-assessment in order to improve one's judgment. Giving learners the ability to actively seek and engage with feedback encourages participation in the feedback cycle, focusing on self-regulation rather than reliance on feedback providers. Feedback and action plan development can be improved by teaching students how to understand criticism, manage emotions constructively, and practice developing evaluative judgment and self-regulation skills. Based on the study findings an integrated three stage training model is recommended for effective self- and peer feedback practice for undergraduate medical education.

Background With general practice becoming an increasingly important part of undergraduate medical education, it is vital to have reliable ways for assessing placement quality. The most prevalent tools for such assessment are the Dundee Ready Education Environment Measure (DREEM) and the Manchester Clinical Placement Index (MCPI). These instruments were not specifically designed for use only in GP contexts and were developed without student involvement at inception. As a result, they may omit quality indicators valued by students on GP placement. This study sought to understand the quality of learning in GP from the student perspective and compare this to what is assessed by DREEM and MCPI. We hope the results of this study will inform the development of placement quality questionnaires inspired by the student voice. Methods Purposive sampling was used to recruit 17 undergraduate medical students in academic years 3–5 at the University of Bristol into four focus groups. These ran from May 2023 to April 2024 and were based on a topic guide developed and agreed on by all authors. Theoretical saturation was achieved as no new themes emerged in the final focus group. The focus groups were recorded and transcribed in full. The transcripts underwent systematic coding using NVivo. The codes formed the basis for the thematic analysis. Results Four main themes emerged: a sense of belonging, quality of learning, efficiency of learning, and the qualities of the GP teacher. These themes are illustrated by pertinent quotes from the focus groups. Subthemes included being given appropriate clinical autonomy within the placement, timely access to resources, structured clinical activities, and tutor qualities such as enthusiasm and leadership. Conclusions This paper offers a new perspective on the quality of GP placements by focusing on the student experience. It identifies themes and subthemes that education teams should assess, beyond what's covered by existing tools like MCPI and DREEM. These include students’ sense of belonging, perceived learning efficiency, and appropriate clinical autonomy. We argue that ignoring these areas neglects key aspects of student needs. We are piloting a new questionnaire incorporating these themes to better identify substandard placements and improve student experiences.

Background Observation during clerkships is challenging for clinical supervisors. Using a video feedback system (VFS) to record consultations with a patient, facilitates asynchronous feedback. Within this system it is also possible to add annotations, linked to a timeline. Learners are facilitated to share both recordings and annotations with others, who can provide feedback at a self-selected moment. Methods A qualitative document analysis on the content of annotations from 23 medical students has been conducted to explore how they use the annotation option in a VFS during their first clerkship. Thematic analysis was chosen as an inductive strategy. Results Thirteen students opted to share their videos for feedback, while ten chose not to. The main themes were “content”, “labeling video fragments” and “responses to shared annotations”. Subthemes within the theme “Content” were ‘Typing’, ‘Empathy’, ‘Directing’ and ‘Communication and communications skills’. Students were critical of themselves, but tempered their feedback by mitigating language. Many students made concise notes to their recordings, without adding questions or interpretations. The provided feedback was carefully phrased and alternatives were formulated. Conclusion Students apply “feedback principles” as they have learned from prior training. Alternatives were carefully constructed. It seems they also assess themselves using short notes similar to items of assessments scales. Their tendency to temper their feedback and not always share the videos with others, may indicate the need for a safe learning environment, as a prerequisite for using a VFS. Considering the diligence in feedback provision and varied topics addressed, the use of a VFS seems to be a good way to provide asynchronous feedback on communication skills during clerkships, offering instructors increased observation opportunities and the chance to facilitate peer feedback.