The Best of Both Worlds: Exploring the Interplay Between Written and Verbal Feedback in the Continuum of Medical Education.

Background: Feedback plays a fundamental role in learning throughout the medical education continuum. Feedback could be provided through written and verbal format to improve students' performance. However, several factors were also found to influence feedback, such as students' and teachers' perceptions, students' receptivity, and cultural aspects, which further emphasized the complexity of the feedback process. Given the continuum of medical education from undergraduate to postgraduate stages, with different needs in each phase, and the importance of both written and verbal feedback in learning, it becomes essential to explore the interplay between verbal and written feedback throughout the continuum of medical education. Methods: A qualitative descriptive study was conducted involving undergraduate medical students and postgraduate medical residents in Faculty of Medicine Universitas Indonesia (FMUI) to explore their perceptions towards verbal and written feedback. Respondents were selected using maximum variation sampling approach and data was collected through focus group discussions (FGD). Thematic qualitative analysis was conducted iteratively. Results: A total of 17 medical students and 13 residents were involved in this study. Two emerging themes were identified: (i) the amplifying effect between written and verbal feedback, and (ii) dynamic changes in the perceived value of feedback. The results highlighted the characteristics of both verbal and written feedback as perceived by trainees, and the benefit of combining the two formats to amplify their strengths, especially for students to engage in reflective dialogue with teachers while also receiving feedback documentation to revisit and facilitate acceptance of the feedback. The findings of this study also emphasized the dynamics of perceived value of both verbal and written feedback throughout the medical education continuum and its influencing factors, which should be considered when designing feedback opportunities catered to each stage in medical education. Conclusion: This study explored the perceived impact and values of verbal and written feedback. Rather than comparing between the two formats, we found that both verbal and written feedback could complement each other to achieve a more impactful feedback, while considering the factors influencing students and residents perceived values of feedback.