Using technology to enhance clinical supervision:

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Using technology to enhance clinical supervision: The Electronically-Facilitated Feedback Initiative (EFFI) Dr Suzanne Snodgrass, Kyle Ball, Professor Darren Rivett, Samantha Ashby Catherine Johnston, Kim Nguyen, Associate Professor Trevor Russell • Introduction • Increased demand for health professionals, more students enrolling in health professional degrees, and a limited number of clinical placements impact on the education of competent health professionals.1New technologies provide opportunities for innovative strategies that may increase clinical placement capacity and improve student learning through enhanced feedback.2 The efficacy of using web-enabled devices to provide student feedback during clinical placements has not been established. • Aim • The aim of this project was to evaluate the Electronically-Facilitated Feedback Initiative (EFFI) in order to determine clinical educator and student perceptions of its utility and value for student learning. • Methods • The EFFI was a pilot trial. Participating clinical educators provided electronic feedback to students on their clinical performance using an iPad(Apple Inc.) and specialised software (Mark-RiteTM, Figure 1). Clinical educators (n = 9) from occupational therapy, physiotherapy and speech pathology used iPads to provide additional formative written feedback to students (n = 19; Figure 2). The system automatically generated an email to students each day containing their individualised feedback. Nine clinical educators completed a survey (100% response rate). Most (77%) found the system easy to use, and some (66%) reported that it improved the quality of feedback to students. All nine clinical educators participated in an interview or focus group. They reported the EFFI provided a useful method for documenting student performance and this was reflected in more accurate reporting for formal assessments. There were difficulties with the use of iPadsin acute hospital settings due to the need for strict hygiene protocols and the assistance required for physically dependent patients. Clinical educators who routinely supervised a single student felt that electronic feedback would enable them to supervise multiple concurrent students. Part-time educators reported it would assist them to share a student’s supervision with another clinical educator, increasing opportunities for student clinical placements. Conclusions Students report electronic feedback is useful for self-reflection and improving performance. Clinical educators find it useful as documentary evidence for formal assessments. The provision of electronic feedback via an iPad may increase the capacity of clinical educators to supervise greater numbers of students in some clinical settings. Figure 3. Likert scale responses from students about the value of the electronic feedback for reflection. Figure 2. Clinical educator providing electronic feedback on student performance. Surveys, interviews and focus groups of students and clinical educators evaluated the EFFI for its utility and whether it improved student learning and performance. Data were analysed using descriptive statistics, Chi-square and content analysis. Results Fourteen students completed a survey (73% response rate). Most (71%) agreed the electronic feedback assisted their reflection (Figure 3), and was specific to their learning needs. Many (69%) agreed the feedback identified areas for improvement (Figure 4) though this differed between disciplines (p = .035), and 64% thought their performance improved as a result (Figure 5). Over half (56%) planned to use the electronic feedback to prepare for their next clinical placement. Eleven students participated in focus groups (58% response rate). Students found it easy to access their feedback via email. They also reported that the EFFI provided a useful method for retaining feedback from clinical educators which would have otherwise been lost or forgotten. Students thought they received more feedback from the EFFI compared to other previous clinical placements. They reported the electronic feedback enabled them to more effectively track their progress throughout the clinical placement. Figure 4. Likert scale responses from students about the value of the feedback for identifying performance gaps. References Health Workforce Australia. (2011). National Health Workforce Innovation and Reform Strategic Framework for Action 2011–2015. Adelaide: Health Workforce Australia. Snodgrass SJ, Russell T, Ashby SE, Rivett DA. Implementation of an electronic Objective Structured Clinical Exam (eOSCE) for assessing practical skills in pre-professional physiotherapy and occupational therapy programs: examiner and course coordinator perspectives. Australian Journal of Educational Technology (under review). Dearnley C, Taylor J, Hennessy S, et al. Using mobile technologies for assessment and learning in practice settings: outcomes of five case studies. International Journal on E-Learning. 2009;8(2):193-207. Acknowledgements This project was supported by a grant from the New South Wales Interdisciplinary Clinical Training Network, Health Education and Training Institute, Health Workforce Australia. Figure 5. Likert scale responses from students about the effect of the electronic feedback on their performance. Figure 1. Mark-RiteTM, as viewed by clinical educators on the iPad.