A randomised controlled trial of feedback to improve patient satisfaction and consultation skills in medical students
Open accessAbstract
Background: The use of feedback has been integral to medical student learning, but rigorous evidence to evaluate its education effect is limited, especially in the role of patient feedback in clinical teaching and practice improvement. The aim of the Patient Teaching Associate (PTA) Feedback Study was to evaluate whether additional written consumer feedback on patient satisfaction improved consultation skills among medical students and whether multisource feedback (MSF) improved student performance. Methods: In this single site, double-blinded randomised controlled trial, 71 eligible medical students from two universities in their first clinical year were allocated to intervention or control and followed up for one semester. They participated in five simulated student-led consultations in a teaching clinic with patient volunteers living with chronic illness. Students in the intervention group received additional written feedback on patient satisfaction combined with guided self-reflection. The control group received usual immediate formative multisource feedback from tutors, patients and peers. Student characteristics, baseline patient-rated satisfaction scores and tutor-rated consultation skills were measured. Results: Follow-up assessments were complete in 70 students attending the MSF program. At the final consultation episodes, both groups improved patient-rated rapport (P = 0.002), tutor-rated patient-centeredness and tutor-rated overall consultation skills (P = 0.01). The intervention group showed significantly better tutor-rated patient-centeredness (P = 0.003) comparing with the control group. Distress relief, communication comfort, rapport reported by patients and tutor-rated clinical skills did not differ significantly between the two groups. Conclusions: The innovative multisource feedback program effectively improved consultation skills in medical students. Structured written consumer feedback combined with guided student reflection further improved patient-centred practice and effectively enhanced the benefit of an MSF model. This strategy might provide a valuable adjunct to communication skills education for medical students. Trial registration: Australian New Zealand Clinical Trials Registry Number ACTRN12613001055796.
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Combining the durability of written feedback with the immediacy and personalization of verbal feedback supports nuanced learning and continuous improvement.
“By combining the durability of written feedback with the immediacy and personalization of verbal feedback, educators create a feedback system that supports nuanced learning and continuous improvement [110].”
From Formative assessment and feedback in medical education: A practical guide: AMEE Guide No. 189 (2026) · cites this paper as [110]
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Cites
Audit and feedback: effects on professional practice and healthcare outcomes
Ivers, N., Jamtvedt, G., Flottorp, S., Young, J. M., Odgaard-Jensen, J., French, S. D., O'Brien, M. A., Johansen, M., Grimshaw, J., & Oxman, A. D. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000259.pub3 · Cited by 5,485 · cited 3× · see citing works
“Our study design consists of elements that are considered highly desirable in a Cochrane study that reviewed the effect of feedback on professional practice: a study population with a low performance baseline, feedback provided more than once and directed towards an action plan using a facilitative framework in promot…”
BackgroundMethodInfluentialLearning Styles and Learning Spaces: Enhancing Experiential Learning in Higher Education
Kolb, A. Y., & Kolb, D. A. (2005) · Academy of Management Learning & Education · doi:10.5465/amle.2005.17268566 · Cited by 4,980 · see citing works
(2003) · Purdue University Indianapolis (Indiana University) · Cited by 2,976 · see citing works
A theory of goal setting & task performance
Locke, E. A., & Latham, G. P. (1990) · Medical Entomology and Zoology · Cited by 2,022 · see citing works
State of the science in health professional education: effective feedback
Archer, J. C. (2010) · Medical Education · doi:10.1111/j.1365-2923.2009.03546.x · Cited by 783 · see citing works
The Consultation: An Approach to Learning and Teaching.
(1984) · Annals of Internal Medicine · doi:10.7326/0003-4819-101-4-577_2 · Cited by 582 · see citing works
Venning, P. (2000) · BMJ · doi:10.1136/bmj.320.7241.1048 · Cited by 494 · see citing works
Shute, V. J. (2007) · ETS Research Report Series · doi:10.1002/j.2333-8504.2007.tb02053.x · Cited by 467 · see citing works
Makoul, G. T., Krupat, E., & Chang, C. (2007) · Patient Education and Counseling · doi:10.1016/j.pec.2007.05.005 · Cited by 442 · see citing works
Kinnersley, P. (2000) · BMJ · doi:10.1136/bmj.320.7241.1043 · Cited by 428 · see citing works
Bickman, L., Kelley, S. D., Breda, C., de Andrade, A. R., & Riemer, M. (2011) · Psychiatric Services · doi:10.1176/appi.ps.002052011 · Cited by 421 · see citing works
Baker, R. (1990) · PubMed · Cited by 360 · see citing works
Developing the role of patients as teachers: literature review
Wykurz, G., & Kelly, D. (2002) · BMJ · doi:10.1136/bmj.325.7368.818 · Cited by 289 · see citing works
Multisource feedback in the assessment of physician competencies
Lockyer, J. (2003) · Journal of Continuing Education in the Health Professions · doi:10.1002/chp.1340230103 · Cited by 284 · see citing works
The consultation: an approach to learning and teaching
Wilson, P. H. (1985) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1985.tb120003.x · Cited by 225 · see citing works
Brinkman, W. B., Geraghty, S. R., Lanphear, B. P., Khoury, J. C., Gonzalez del Rey, J. A., DeWitt, T. G., & Britto, M. T. (2007) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.161.1.44 · Cited by 204 · see citing works
The 'Medical Interview Satisfaction Scale' (MISS-21) adapted for British general practice
Meakin, R. (2002) · Family Practice · doi:10.1093/fampra/19.3.257 · Cited by 196 · see citing works
The Reliability, Validity, and Feasibility of Multisource Feedback Physician Assessment
Donnon, T., Ansari, A., Alawi, S. A., & Violato, C. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000147 · Cited by 190 · see citing works
Bokken, L., Rethans, J.-J., Scherpbier, A. J. J. A., & van der Vleuten, C. P. M. (2008) · Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0b013e318182fc56 · Cited by 174 · see citing works
Reese, R. J., Usher, E. L., Bowman, D. C., Norsworthy, L. A., Halstead, J., Rowlands, S., & Chisholm, R. (2009) · Training and Education in Professional Psychology · doi:10.1037/a0015673 · Cited by 130 · see citing works
Joshi, R., Ling, F. W., & Jaeger, J. (2004) · Academic Medicine · doi:10.1097/00001888-200405000-00017 · Cited by 124 · see citing works
Ferguson, J., Wakeling, J., & Bowie, P. (2014) · BMC Medical Education · doi:10.1186/1472-6920-14-76 · Cited by 102 · see citing works
Improving patient satisfaction through physician education, feedback, and incentives
Banka, G., Edgington, S. E., Kyulo, N. L., et al. (2015) · Journal of Hospital Medicine · doi:10.1002/jhm.2373 · Cited by 99 · see citing works
Feedback in Medical Education: A Critical Appraisal
Kornegay, J. G., Kraut, A., Manthey, D. E., Omron, R., Caretta‐Weyer, H. A., Kuhn, G. J., Martin, S., & Yarris, L. M. (2017) · AEM Education and Training · doi:10.1002/aet2.10024 · Cited by 77 · see citing works
Multisource Feedback to Assess Surgical Practice: A Systematic Review
Khalifa, K. A., Ansari, A., Violato, C., et al. (2013) · Journal of surgical education · doi:10.1016/j.jsurg.2013.02.002 · Cited by 42 · see citing works
Reinders, M. E., Blankenstein, A. H., van der Horst, H. E., Knol, D. L., Schoonheim, P. L., & van der Horst, H. E. (2010) · Medical Education · doi:10.1111/j.1365-2923.2009.03569.x · Cited by 41 · see citing works
The use of instructor-patients to teach physical examination techniques
Anderson, K. K., & Meyer, T. C. (1978) · Academic Medicine · doi:10.1097/00001888-197810000-00006 · Cited by 32 · see citing works
Barr, J., Ogden, K., & Rooney, K. (2010) · International Journal of Consumer Studies · doi:10.1111/j.1470-6431.2010.00910.x · Cited by 20 · see citing works
Lai, M. M. Y., Roberts, N., & Martin, J. A. (2014) · Trials · doi:10.1186/1745-6215-15-361 · Cited by 13 · see citing works
Self-citationMultisource feedback to assess pediatric practice: a systematic review
Alawi, S. A., Ansari, A., Raees, A., et al. (2013) · Canadian Medical Education Journal · doi:10.36834/cmej.36621 · Cited by 10 · see citing works
Barr, J., Ogden, K., Radford, J. C., & Rooney, K. (2009) · Medical Education · doi:10.1111/j.1365-2923.2009.03377.x · Cited by 8 · see citing works
Crossley, J. G. M. (2015) · Journal of Continuing Education in the Health Professions · doi:10.1002/chp.21273 · Cited by 7 · see citing works
Farquhar, D. (2000) · Academic Medicine · doi:10.1097/00001888-200005000-00063 · Cited by 6 · see citing works
Improving ambulatory patient‐centred practice with a patient teaching associate programme
Lai, M. M. Y., Martin, J., & Roberts, N. (2015) · Internal Medicine Journal · doi:10.1111/imj.12813 · Cited by 4 · see citing works
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Research works printed but not linked: 1
- [28]Ogden K, Barr J, Hill A, Summers M, Mulligan B, Rooney K. Validating a tool designed to assess medical students’ patient-centred capabilities and integration of consultaiton skills. 15th International conference on assessment competence in medicine and healthcare professions; Kuala Lumpur; 2012.
- Authors
- Lai, M. M. Y., Roberts, N., Mohebbi, M., & Martin, J.
- Affiliations
- Deakin University (AU)
- Corresponding author
- Lai, Michelle M. Y.
- Venue
- BMC Medical Education
- Published
- 2020-08-20
- Volume
- 20
- Issue
- 1
- Pages
- 277-277
- ISSN
- 1472-6920 (ISSN-L)
- PMC
- PMC7439652
- OpenAlex
- W3080760279
- Cited by
- 31
- References
- 35
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 8 · 2023: 1 · 2022: 8 · 2021: 7
- FWCI
- 2.99
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medical Education (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- Faculty of Medicine, Nursing and Health Sciences, Monash University (CF13/779 - 2013000356)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- multisource feedback, consultation skills, medical students, patient-centered care, self-reflection, simulated consultations, chronic disease patients, communication skills education, clinical teaching
- MeSH terms
- Australia, Clinical Competence, Education, Medical, Undergraduate, Feedback, Humans, Referral and Consultation, Students, Medical, Teaching, Patient Satisfaction
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