Work-based feedback conversations with GP teachers.

Introduction: Feedback may play out in the general practice workplace less usefully than anticipated by educators. We investigated work-based feedback conversations about directly observed student tasks embedded in the supervisor's clinical consultations with patients.

Methods: Feedback conversations between GP teachers and medical students and subsequent student reflections were audio-recorded. Student and GP teacher focus groups were also conducted and transcribed professionally. An iterative, qualitative descriptive analysis integrating all transcripts was undertaken. Findings are discussed under the descriptive categories of feedback structure, content and perceived value.

Results: Twenty feedback conversations (total duration of 85 min) between five GP teachers, nine students and 20 student reflections (total duration of 58 min) were analysed. GP teachers actively engaged students in reflection and used balancing scripts and soft correction strategies. Students appeared to have some difficulty steering feedback conversations, which focused more on general skills than case-specific content knowledge. The recorded conversations were fragments of ongoing, in-practice teaching and learning, explicit and implicit. Student reflections suggested that they were able to grasp learning points effectively and identify room for growth. Praise and positive self-feedback appeared to reassure students, particularly when they were disappointed by their performances.

Discussion: Formal 'set-piece' feedback conversations may be a useful opportunity to explicitly surface and/or reinforce previous 'in-practice' reflection and feedback using a systematic structure. They may also reassure and encourage students and foster positive educational alliances. Students value in-practice and on-practice feedback but may prefer more control of the latter conversations.