Formative feedback to students: the mismatch between faculty perceptions and student expectations.

BACKGROUND: Formative assessments and other learning tools are ineffective in the absence of formative feedback. METHODS: A study was carried out on preclinical students and teachers using mixed methods approach that included questionnaire surveys, focus group discussions and post survey discussions to determine perceptions and expectations of students on feedback and those of teachers. RESULTS: Students expected formative feedback to be incorporated into all teaching activities from the beginning of the course in medicine to promote self regulated and self directed learning. Students stated that provision of model answers and grades in assessments are inadequate but require teacher student dialogue sessions to clarify issues. Students considered immediate feedback or feedback within two weeks on a written activity, simple but focused, by a content expert would be the best form. In contrast, the teachers perceived the feedback provided using a model answer by a non content expert to be acceptable. Students also believed that formative feedback is of particular importance in salvaging poor performers. CONCLUSIONS: There is a need to create awareness among teachers on the usefulness of this tool in higher education and for moulding teaching practices by including training on this aspect of teaching-learning, in routine faculty development activities. The study showed the importance of including feedback as a generic feature in all learning activities, and this may require incorporating into institutional policy for successful implementation.

Imaging as an aid to the diagnosis of acute appendicitis.

Acute appendicitis has been known as a disease entity for well over a century but a confident diagnosis before surgery in all patients suspected of the condition is still not possible. Timely diagnosis is essential to minimise morbidity due to possible perforation of the inflamed organ in the event treatment is delayed; so much so that surgeons often preferred to operate at the slightest suspicion of the diagnosis in the past. This resulted in the removal of many normal appendixes. When the diagnosis of appendicitis is clear from the history and clinical examination, then no further investigation is necessary and prompt surgical treatment is appropriate. Where there is doubt about the diagnosis however it is advisable to resort to imaging studies such as abdominal ultrasound or computed tomography to clear such suspicions before subjecting the patient to an appendicectomy. These studies would also help avoid delays in surgery in deserving patients.