Monday, June 9, 2008

Feedback...feedback and more feedback

Half of the joy of being a student is getting feedback from our supervising physiotherapists so inevitably we can better our performance and for the future make ourselves better clinicians. On my community placement you visit several venues to take classes which are specialised depending on the diagnoses of the cliental and at each venue a different physiotherapist acts as your supervisor. So in a week you are assessed by several physiotherapists whom all give you feedback. In a sense this can be quite advantageous as each physio seems to pick up a different strength and weakness in your performance and give you confidence in your abilities and suggestions for improvement, however when the feedback you receive conflicts itself it isvery confusing in establishing areas for improvement. This became particularly tough for me last week.
In my week i take 3 abilities classes at different venues with different physiotherapists. All of the clients whom are prescribed this program present with very similar diagnoses; in summary these clients required exercise which focuses on balance and retraining functional tasks also incorporating strength training and aerobic exercises. As last week was my mid placement assessment every physio had a discussion with me about my performance. By mid week i was particularly confident in myself as all physios really liked my class plans and the feedback i had received was fairly consistent, my curtin tutor included. So i decided to keep the same class plan i had maintained in my first 2 abilities classes for my third abilites class which was to be on friday morning.
After teaching this class i felt particularly confident as the two physios who had watched me in the week both liked my class plan and really liked how the exercises precription was very appropriate to the population i was dealing with. However when speaking to my friday supervisor all that positive feedback i had received prior seemed to have went down the gurgler. My friday supervisor really did not like my class plan and thought it lacked creativity (which i was told was my strong point) and did not focus on the client's problems. She felt i did not show as much personality in the class and that after seeing all of my preparation she felt a bit let down.
I really could not understand this...i had used this class plan twice and both physios prior had loved it... why was this physio giving me a hard time....I was quite frustrated because how was i to make sense of this feedback to improve?
I think this situation brings to light the importance of evaluating our performance on a more global scale than isolating how we treated someone, or how we performed to one separate occasion. I think what i learnt over the last week about evaluating my own performance was to pay more close attention to consistent feedback than feedback from one separate occasion. I think this can be applicable to any prac...in 4/5 weeks you receive lots and lots of feedback and to try better every single attribute just leaves you chasing your own tail and losing sight on a global scale of what can be improved and what "weaknesses" can be bettered with the more clinical experience you have. A culmination of so many external factors can contribute to why you did not perform your best on the day.The next time i take this class rather than completely renovating my class plan i have collaborated feedback from all my supervisors and picked three things i want to show i have imrpoved on... Has anyone else had a confliction in feedback from supervising physios that effected your own self evaluation....and if so what did you do to gain a fuller picture of your abilities? Rach

1 comment:

patton said...

I understand completely how this can occur, although it has not yet happened to me. For two out of the three of my placements so far I have had only the one supervisor for the placement, so their feedback was consistent. For the placement where I had both a Curtin and a facility supervisor their feedback focused on different aspects, however, were not conflicting.

Since the start of this course I have questioned the ability to standardise OPSE’s and clinical placements. There are too many variables to completely standardise these, although the university does its best to attempt to. The level of assistance from students acting as patients in OSPE’s, as well as their body size can completely change the manual handling of the patient. Not to mention the fact that although there are specific standardised requirements, it would be naive to think that the different supervisors would not interpret these differently or at least perceive some things differently. However, the procedures for practical assessment that are in place are pretty much as standard as possible to implement and it could be far worse.

I think this OPSE ideology can be applied to clinical placements. We are all going to see completely different patients from student to student wherever we are. Not to mention that our supervisors will vary greatly. One student who may be deemed not competent by one supervisor, could very well be considered competent by another had they been in a different facility for that placement. There is no way around this as clinical experience is such an important part of our learning, and it is not feasible to all be exposed to the same clinical placements or to see the same types of patients.

I feel as though you should take in as much feedback as you can and try to pick out important aspects, as you have, to apply to future practice, however, sometimes you may have to take some feedback with a grain of salt. Different supervisors will see things differently, it doesn’t mean that either are right or wrong, they just may differ in opinions, attitudes or expectations. I think that the important thing as a student is to take in as much feedback as we can and apply it to the future. To gain a fuller picture of your abilities I would suggest that during feedback sessions you ask the supervisor to explain why they have said what they have said. And if you disagree with something, for you to discuss this as it can often clarify some issues. It is also useful to look back on previous placements assessment forms so you can compare feedback and determine whether or not you are improving in specific aspects. However, when comparing assessment forms also consider that each supervisor will have different opinions!