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Background: Developments in educational technology and learning analytics make it possible to automatically formulate and deploy personalized formative feedback to learners at scale. However, to be effective, the motivational and emotional impacts of such automated and personalized feedback need to be considered. The literature on feedback suggests that effective feedback, among other features, provides learners with a standard to compare their performance with, often called a reference frame. Past research has highlighted the emotional and motivational benefits of criterion‐referenced feedback (i.e., performance relative to a learning objective or mastery goal) compared to norm‐referenced feedback (performance relative to peers). Objectives: Despite a substantial body of evidence regarding reference frame effects, important open questions remain. The questions encompass, for example, whether the benefits and drawbacks of norm‐referenced feedback apply in the same way to automated and personalize feedback messages and whether these effects apply to students uniformly. Further, the potential impacts of combining reference frames are largely unknown, even though combinations may be quite frequent in feedback practice. Finally, little research has been done on the effects of reference frames in computer‐supported collaborative learning, which differs from individual learning in meaningful ways. This study aims to contribute to addressing these open questions, thus providing insights into effective feedback design. Specifically, we aim to investigate usefulness perceptions as well as emotional and motivational effects of different reference frames—and their combination—in automated and personalized formative feedback on a computer‐supported collaborative learning task. Methods: A randomized field experiment with four feedback conditions (simple feedback, norm‐referenced, criterion‐referenced, and combined feedback) was conducted in a course within a teacher training program (N = 282). Collaborative groups worked on a learning task in the online learning environment, after which they received one of four possible automated and personalized formative feedback. We collected student data about feedback usefulness perceptions, motivational regulation, and achievement emotions to assess the differential effects of these feedback conditions. Results: All feedback types were perceived as useful relative to the simple feedback condition. Norm‐referenced feedback showed detrimental effects for motivational regulation, whereas combined feedback led to more desirable motivational states. Further, criterion‐referenced feedback led to more positive emotions for overperformers and to more negative emotions for underperformers. The findings are discussed in light of the broader feedback literature, and recommendations for designing automated and personalized formative feedback messages for computer‐supported collaborative learning are presented. Lay Description: What is already known about this topic: Automated and personalized feedback based on Learning Analytics can provide students with feedback at scale.Reference frames, a key design feature of any feedback, are essential to consider regarding their emotional and motivational impacts. What this paper adds: Students deemed all automated and personalized feedback more useful than the minimal feedback condition.The choice of reference frames matters for personalized and formative feedback in a computer‐supported collaborative learning task.The social comparison reference frame was largely detrimental, whereas a combination of reference frames can induce desirable motivational regulation.Criterion‐referenced feedback led to more positive emotions for overperformers and more negative emotions for underperformers. Implications for practice and/or policy: Practitioners should carefully consider the reference frames that underlie their feedback designs.Social comparison should largely be avoided, unless in combination with other, more informative feedback information. [ABSTRACT FROM AUTHOR]

Purpose: Magnetic resonance-guided radiotherapy (MRgRT) has recently been introduced in our institution. As MRgRT requires high patient compliance compared to conventional techniques and can be associated with prolonged treatment times, feasibility and patient tolerance were prospectively assessed using patient-reported outcome questionnaires (PRO-Q)., Materials and Methods: Forty-three patients were enrolled in a prospective observational study and treated with MRgRT on a low-field hybrid Magnetic Resonance Linear Accelerator system (MR-Linac) between April 2018 and April 2019. For assistance in gated breath-hold delivery using cine-MRI, a video feedback system was installed. PRO-Qs consisted of questions on MR-related complaints and also assessed aspects of active patient participation., Results: The most commonly treated anatomic sites were nodal metastases and liver lesions. The mean treatment time was 34 min with a mean beam-on time of 2:17 min. Gated stereotactic body radiotherapy (SBRT) was applied in 47% of all patients. Overall, patients scored MRgRT as positive or at least tolerable in the PRO‑Q. Almost two thirds of patients (65%) complained about at least one item of the PRO‑Q (score ≥4), mainly concerning coldness, paresthesia, and uncomfortable positioning. All patients reported high levels of satisfaction with their active role using the video feedback system in breath-hold delivery., Conclusion: MRgRT was successfully implemented in our clinic and well tolerated by all patients, despite MR-related complaints and complaints about uncomfortable immobilization. Prospective clinical studies are in development for further evaluation of MRgRT and for quantification of the benefit of MR-guided on-table adaptive radiotherapy.

Objectives: Feedback is one of the most important methods for competency-based teaching. A survey was conducted to learn more about the use of feedback methods at five medical faculties. Methods: In the 2017 summer semester, teachers at Baden-Wurttemberg's medical schools in Freiburg, Heidelberg, Mannheim, Tuebingen and Ulm were invited to participate in the survey. The link to the questionnaire was sent to the teaching coordinators at the various departments at each of the five medical schools. The teaching coordinators were asked to forward the link to the questionnaire to all instructors in their department. At one location, all instructors were directly addressed. The data were collected online. Results: A total of 464 instructors participated in the survey. Most consider feedback in medical education as important (23%) or very important (72%). However, some feedback methods are hardly used. The reason for this is, in particular, that some of the feedback methods are unfamiliar, e.g. checklists (56%), or not considered necessary by the instructors, e.g. written feedback (31%). Fifty-five percent of the instructors would like to receive further education or information on feedback. Conclusion: The results show that the use of feedback methods in medical teaching is expandable and that teachers find feedback to be important. Accordingly, nothing should stand in the way of a greater use of feedback methods in teaching. However, in order for this to happen, it is important that instructors are made more familiar with feedback methods., Competing Interests: The authors declare that they have no competing interests.

Objective: Our aim was to develop and evaluate a two-module training program (KOKOS-Rheuma) specifically designed to enhance the ability of persons with rheumatic and musculoskeletal diseases to communicate in various everyday situations., Design: KOKOS-Rheuma deals with communication at work (particularly superiors), with physicians, acquaintances, strangers and staff members of authorities and institutions and focuses on communication skills such as "saying no" and "giving and receiving feedback." Members of the German League against Rheumatism (GLR) were trained to deliver the program to self-help groups over two sessions or in a full-day session. The participants, trainers and observers completed a short evaluation form after each module or at the end of the full-day session., Main Outcome Measures: The evaluation was based on 232 participant, 51 trainer, and 8 observer evaluation forms., Results: The participants rated all aspects of the training as good. The training was rated higher in the single session format. The great majority would recommend the course to other people., Conclusion: After the revision of the training manual, KOKOS-Rheuma can be recommended for inclusion in the training schedule of the GLR. We recommend that future trainers receive more extensive preparation for delivering the course that highlights the preparation time required.

Introduction: Progress testing is a special form of longitudinal and feedback-oriented assessment. Even though well established in human medical curricula, this is not the case in dental education. The aim was the prospective development and implementation of the first reported German-language Dental Progress Test (DPT) for the undergraduate dental curriculum at the Medical University of Graz, Austria., Material and Methods: Participation in DPT was compulsory for all dental students in terms 7-12 (years 4-6). Three tests, each consisting of 100 items out of a pool of 375, were administered within 3 consecutive terms in 2016 and 2017. Rasch analyses were used to evaluate the questionnaire and identify misfitting items., Results: In the item responses, 59.7% were "correct," 27.0% were "false" and 13.3% were answered with "don't know," with similar results at all 3 time points. The assumption of parallel ICC was met (T1: χ 2  = 51.071, df = 74, P = .981; T2: χ 2  = 57.044, df = 67, P = .802; T3: χ 2  = 58.443, df = 72, P = .876) and item difficulties for the thematic fields were similarly distributed across the latent dimensions., Conclusion: The newly introduced DPT is appropriate for testing dental students and is well balanced for the tested target group., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Student evaluations of teaching can provide useful feedback for teachers and programme coordinators alike. We have designed a novel evaluation tool assessing teacher performance and student learning outcome. This tool was implemented at two German medical schools. In this article, we report student and teacher perceptions of the novel tool, and the implementation process., Methods: Focus group discussions as well as one-to-one interviews involving 22 teachers and 31 undergraduate medical students were conducted. Following adjustments to the feedback reports (e.g. the colour coding of results) at one medical school, 42 teachers were asked about their perceptions of the revised report and the personal benefit of the evaluation tool., Results: Teachers appreciated the individual feedback provided by the evaluation tool and stated that they wanted to improve their teaching, based on the results; however, they missed most of the preparative communication. Students were unsure about the additional benefit of the instrument compared with traditional evaluation tools. A majority was unwilling to complete evaluation forms in their spare time, and some felt that the new questionnaire was too long and that the evaluations occurred too often. They were particularly interested in feedback on how their comments have helped to further improve teaching. Student evaluations of teaching can provide useful feedback CONCLUSION: Despite evidence of the utility of the tool for individual teachers, implementation of changes to the process of evaluation appears to have been suboptimal, mainly owing to a perceived lack of communication. In order to motivate students to provide evaluation data, feedback loops including aims and consequences should be established., (© 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Background: Constructive feedback is an essential element of the educational process, helping trainees reach their maximum potential and increasing their skill level. Video-based feedback has been described as highly effective in various educational contexts. The present study aimed to evaluate the feasibility and acceptability of video-based, on-ward supervision for final year students in a clinical context with real patients., Methods: Nine final year medical students (three male, six female; aged 25.1 ± 0.7 years) and eight patients (five male, three female; aged 59.3 ± 16.8 years) participated in the pilot study. Final year students performed routine medical procedures at bedside on internal medicine wards at the University of Heidelberg Medical Hospital. Students were filmed and were under supervision. After performing the procedures, an oral feedback loop was established including student, patient and supervisor feedback on communicative and procedural aspects of skills performed. Finally, students watched their video, focusing on specific teachable moments mentioned by the supervisor. Written evaluations and semi-structured interviews were conducted that focused on the benefits of video-based, on-ward supervision. Interviews were analysed qualitatively, using open coding to establish recurring themes and overarching categories to describe patients' and students' impressions. Descriptive, quantitative analysis was used for questionnaire data., Results: Supervised, self-chosen skills included history taking (n = 6), physical examination (n = 1), IV cannulation (n = 1), and ECG recording (n = 1). The video-based, on-ward supervision was well accepted by patients and students. Supervisor feedback was rated as highly beneficial, with the video material providing an additional opportunity to focus on crucial aspects and to further validate the supervisor's feedback. Students felt the video material would be less beneficial without the supervisor's feedback. The setting was rated as realistic, with filming not influencing behaviour., Conclusion: Video-based, on-ward supervision may be a powerful tool for improving clinical medical education. However, it should be regarded as an additional tool in combination with supervisors' oral feedback. Acceptance was high in both students and patients. Further research should address possibilities of efficiently combining and routinely establishing these forms of feedback in medical education.