Reconsidering the Role of Synchronous Feedback in Learning Diagnostic Skills: Identifying the Impact of the Instructor

Abstract

Introduction: This thesis hypothesized that synchronous feedback which is supportive in nature would have a positive impact on the learning and transfer of the skills of visual and auditory cue identification in osteopathic diagnostic procedures. It was believed that the positive impact of supportive feedback would be evident through accurate identification of both visual and auditory cues. The categories of cues were visually identifiable asymmetrical motion, visual or auditory expressions of pain, and visually identifiable cues of a possible soft tissue tear or motor nerve issue. Methods: All participants received the same video-based learning resource which was optimized for content (what/how) and cognition (why) followed by the same instructions for the practice phase. During the practice phase all participants were shown a video of a previously learned diagnostic procedure which contained visual and auditory cues. Between videos, participants were all asked the same questions in the same order. In the Supportive Feedback with Specific Content (SC) group participants would receive supportive comments regardless of accuracy of answers and, if they had identified an appropriate physical phenomenon but ascribed it to an incorrect category, they would receive feedback to correct the categorization error. The Supportive Feedback (S) group would receive supportive comments regardless of accuracy of answers but no feedback in relation to categorization errors. The No Feedback (NF) group would receive no supportive comments or feedback in relation to categorization errors. Responses were coded as accurate detection of cues, or categorization errors (detection of cues that were not there, or incorrect categorization of cues). Results: All groups performed similarly with respect to accurate identification of auditory and visual cues such that there was no identifiable impact in relation to group condition during both the practice and transfer phases. The SC group did commit less categorization errors (11.43%) when compared to the S (28.21%) and NF (31.43%) groups. Conclusion: The experimental findings supported the hypothesis that supportive feedback enhanced learning outcomes. While not demonstrated through accuracy of cue identification, this was demonstrated through a reduction in cue categorization errors. An additional hypothesis generated from the results of this thesis is that educational designs that allow for the commission of errors by learners followed by correction in the form of direct feedback or group lecture may predict faster attainment of expertise as noted in the reduction of errors.