ABSTRACT
BACKGROUND: High-quality feedback is fundamental to students' learning. We describe and evaluate FEEDBK, a novel feedback tool that encompasses the focus of learning, student self-evaluation (reflection), the encounter with the patient (professionalism), one task that the student should continue to do (reinforcement), one task that they could do better (improvement) and a key take-home message for self-directed learning. METHODS: Medical students received regular bedside teaching and feedback during a 9-week clinical placement at a teaching hospital. Teaching fellows gave feedback in their usual style during weeks 1-3 and then used the FEEDBK tool during weeks 4-9. Questionnaires and focus groups were used to evaluate the students' experience of feedback before and after the introduction of FEEDBK. RESULTS: FEEDBK significantly enhanced the feedback experience across six domains: identifying learning objectives, chance to reflect, feedback on communication skills/professionalism, specific suggestions for improvement, clear take-home message and personalised feedback. The analysis of the feedback from focus groups yielded four categories: (i) FEEDBK influenced the feedback process (delivering timely feedback); (ii) the nature of the feedback (enhancing both the quantity and the quality of the feedback received); (iii) the structure of the feedback; and (iv) the evolution of teaching and learning. DISCUSSION: FEEDBK may enhance both the quantity and the quality of feedback and has the potential to improve the quality of teaching. It provides teachers with a quick and easy-to-follow framework to signpost curriculum-aligned feedback.
Subject(s)
Education, Medical, Undergraduate , Students, Medical , Curriculum , Feedback , Humans , Learning , TeachingABSTRACT
BACKGROUND: It is a common practice to secure both mesh and peritoneum using tacks when performing a transabdominal preperitoneal (TAPP) inguinal hernia repair. The use of tacks to secure the mesh is well documented and has been associated with postoperative chronic pain. Recently, fibrin glue has been used to secure the mesh in these repairs but not used to reapproximate the incised peritoneum. This study assessed the technical feasibility of using fibrin glue for fixation of both mesh and peritoneum. PATIENTS AND METHODS: A total of 33 TAPP hernia repairs were carried out in 27 consecutive patients. In all the patients, both mesh and peritoneum were secured with fibrin glue (20 primary inguinal hernia repairs, 5 bilateral hernia repairs, 1 recurrent inguinal hernia, and 1 recurrent bilateral hernia repair). RESULTS: Patients were followed up at an outpatient clinic between the second and third week after surgery. Six patients were followed up through telephone. Patients were questioned on the following factors: residual postoperative pain (groin and port sites), unplanned GP or hospital visits, employment status and number of days between their surgery and return to both work and normal activities, and recurrence. No patients had residual groin or port site pain at a median of 21 days after surgery. No patient required an unplanned follow-up appointment with their GP. One patient (recurrent repair) developed a seroma postoperatively. Median time to normal activities was 10 days (range, 3 to 21 d). CONCLUSIONS: Total glue fixation of mesh and peritoneum is technically feasible and early results show low rates of postoperative complications and pain. Randomized studies are needed to confirm this.
