피드백에 대한 반응 이해: 조절초점이론의 잠재력과 한계(Med Educ, 2012)

피드백에 대한 반응 이해: 조절초점이론의 잠재력과 한계(Med Educ, 2012)

Understanding responses to feedback: the potential and limitations of regulatory focus theory

Christopher Watling,1 Erik Driessen,2 Cees P M van der Vleuten,2 Meredith Vanstone3 & Lorelei Lingard4

도입

INTRODUCTION

그러나 점점 더 피드백에 대한 학습자 수용의 문제에 대한 관심이 점차 커지고있다.

Increasingly, however, attention has also been paid to the critical issue of learner receptivity to feedback.4,5

임상 훈련 중받은 피드백이 학습자에게 영향을 미치지 못하는 결과를 초래할 수 있다는 사실은 놀랍지 않다.

That feedback received during clinical training may fail to impact learners should not come as a surprise.

그러나 메타 분석에 의하면 피드백 개입의 효과가 긍정적 피드백과 부정적 피드백 사이에 차이가 있다는 어떠한 증거도 발견되지 않았다. 즉, [성공에 대한 정보를 제공하는 긍정적 인 피드백]과 [실패에 대한 정보를 제공하는 부정적인 피드백]은 수행능력에 미치는 영향에 차이가 없었다. 부정적 피드백은 표면적으로 긍정적 인 피드백보다 자존감을 위협 할 가능성이 더 커 보이기 때문에, 피드백의 sign이 효과에 미치는 영향이 없다는 것은 역설적인 것처럼 보인다.

meta-analysis found no evidence, however, that the effects of feedback interventions were moderated by feedback sign: that is, positive feedback, which provides information about success, and negative feedback, which provides information about failure, did not differ in their effects on performance.8 As negative feedback would seem, on the surface, to have greater potential to threaten self-esteem than positive feedback, this lack of influence of the sign of the feedback on its effectiveness seems paradoxical.

• 성취초점은 포부와 성취에 중점을 둡니다. 개인은 희망이나 희망으로 목표를 경험하고 보상의 성취에 동기 부여됩니다. 

• 예방초점은 책임과 안전에 관한 것이다. 개인은 의무 또는 필수품으로 목표를 경험하고 고통 또는 처벌을 피함으로써 동기 부여를 얻습니다. 

• 성취 초점은 우리가 하고 싶은 것들에 관한 것이지만, 

• 예방 초점은 우리가 해야 하는 것에 관한 것입니다.

Promotion focus is concerned with aspirations and accomplishments; individuals experience goals as wishes or desires and are motivated by the achievement of rewards. Prevention focus is concerned with responsibilities and safety; individuals experience goals as obligations or necessities, and are motivated by the avoidance of pain or punishment. Essentially, promotion focus concerns those things we want to do, whereas prevention focus concerns those things we have to do.10

조절 초점은 chronic하게 유지되는 개인의 특성 일 수 있으며, 업무에 대한 일반적인 접근 방식에 영향을 미칠 수 있지만, 업무의 성격과 그것이 발생하는 시나리오 또는 맥락과 같은 상황적 요인에 의해서도 유발 될 수도 있습니다 .11

Although regulatory focus may be a chronic trait of individuals and may influence their general approach to tasks, it may also be induced situationally by factors including the nature of the task and the scenario or context in which it occurs.11

그러므로 조절초점 이론은 피드백에 대한 반응의 다양성에 대한 통찰력을 제공 할 수 있지만, 이러한 실험 결과가 피드백에 대한 반응의 현실이 좌절감을 주는 복잡한 실제 상황에서는 얼마나 잘 적용될 수 있을까?

Regulatory focus theory may therefore offer insight into the variability in responses to feedback, but how well do these experimental findings translate to real clinical situations in which the reality of responsiveness to feedback seems frustratingly complex?

방법

METHODS

This study involved a focused analysis of data collected as part of a larger study in which we examined the experiences that doctors considered to have been influential in their learning.13 In this section, we will briefly describe our approach to data collection and analysis in that original study (Phase 1), and then detail our approach to the additional data analysis that constituted the present study (Phase 2). 

We approached both the present study and the original study using constructivist grounded theory, which attempts to provide a plausible interpretation of a studied phenomenon, while explicitly acknowledging that this interpretation is a construction influenced by the vantage points of researchers and participants alike.14

Phase 1

A purposive sample of early-career academic faculty staff was recruited from a single large Canadian medical school. All faculty members within the first 5 years of their initial academic appointment received an e-mail introducing the study and inviting their participation. We targeted this group because we sought individuals who were able to reflect meaningfully on their training with the benefit of time and distance from it, but who remained close enough to their training to recall important details.

Data collection and analysis proceeded in an iterative fashion. 

• Twenty-two (10 male, 12 female) faculty members representing a range of medical and surgical specialties (internal medicine [n = 3], psychiatry [n = 4], oncology [n = 3], surgery [n = 4], neurology [n = 4], paediatrics [n = 3], medical genetics [n = 1]) participated in individual, semistructured interviews lasting up to 1 hour. 

• The interview approach to data collection was chosen because we were interested in uncovering the internal, psychological dimensions of drawing meaning from learning experiences. 

• Within these interviews, which centred on exploring experiences recalled as meaningful or influential, participants were specifically asked to describe experiences of receiving feedback during their clinical training and to comment on the impact of that feedback. 

• Consistent with a constructivist grounded theory approach, our data collection was not guided by any particular theoretical orientation (including regulatory focus theory); rather, we simply asked participants to describe significant instances of receiving feedback without employing interview questions that explicitly probed existing theoretical concepts. Interviews were recorded and transcribed verbatim without identifying data. 

• Interview data were analysed using the constant comparative approach customary in grounded theory.15 

• Analysis occurred alongside and informed data collection, and the interview strategy evolved during the study to facilitate the exploration of emerging themes. 

• The examination and re-examination of the transcripts facilitated the development of a robust coding scheme for organising and classifying data thematically. Consistent with a theoretical sampling approach, data collection continued until saturation of themes was achieved.14

Phase 2

From the first analytic phase there emerged a grounded theory in which clinical learning was conceptualised as a process by which learners, as they participate in clinical work, encounter a variety of learning cues, including feedback, that compete for their attention. 

• In this grounded theory, which we have described in detail elsewhere,13 the ultimate influence of these learning cues relates largely to learners’ judgements of their credibility. 

• The highly variable descriptions of responses to feedback contained within our data suggested that the process by which feedback becomes influential was deserving of greater scrutiny. 

• We thus undertook a second analytic phase, drawing on the constructivist grounded theory tenet that after a grounded theory emerges, it is appropriate to consider how existing theoretical frameworks might complement or extend the data interpretation or offer alternative explanations for challenging data. 

• This process of weaving existing sensitising concepts into a second level of analysis has the capacity to enhance the explanatory power of the emerging theory, as well as to allow the examination of how the emergent grounded theory ‘extends, transcends, or challenges’ significant ideas in the field.14 

• With these principles in mind, we recognised that regulatory focus theory and, in particular, Kluger and van Dijk’s9 recent descriptions of its usefulness in explaining responses to feedback in experimental situations might illuminate our understanding of the challenging issues associated with response to feedback that emerged prominently from our data.

We thus re-examined all data relating to feedback through the theoretical lens of regulatory focus. 

• Because our study was concerned with individual perspectives on learning experiences, we wanted to ensure that we analysed all instances that participants perceived as feedback. 

• We therefore defined feedback simply and broadly as any information about performance that participants recalled receiving during their clinical training; if a participant perceived an experience as ‘feedback’, it was considered in our analysis.

These data were not restricted to a single coding category, but, rather, were contained within a number of categories and thus the full original dataset was carefully mined for relevant examples. 

• The dataset was then re-coded using the theoretical framework of regulatory focus: two investigators independently analysed each example to determine, when possible, the dominant regulatory focus based on the task described and on the individual’s apparent approach to the task. 

• They then met to compare their interpretations, resolving disagreements through discussion. 

• Particular attention was paid to examples that were discordant or disconfirming to ensure that the analysis could account for their occurrence. 

• To further enhance the rigour of the analysis, selected examples were reviewed by a third investigator and discussions among investigators were used to achieve interpretive consensus. 

• Although all examples from the original dataset that involved feedback were examined for this study, some examples lacked sufficient information on either the task itself or the participant’s mindset as he or she approached the task for an opinion to be formed regarding the likely regulatory focus that was active. 

• Care was taken to avoid forcing such examples; we simply classed these instances as providing insufficient information to allow a meaningful interpretation of regulatory focus.

Reflexivity is an important consideration in the process of data collection and analysis in this type of research. 

• The first author, who conducted the majority of the interviews, is a specialist doctor and thus has shared with the study participants the experience of receiving feedback during clinical training. 

• Reflecting on these personal feedback experiences was a useful and, indeed, necessary element of the analytic process. 

• The other authors are education researchers who are not doctors, and their perspectives were important in facilitating a balanced rendering of the data.

결과

RESULTS

성취초점

Promotion focus

성취초점은, 특히 전환transition 과정이 학습자에게 새로운 목표와 열망을 불러 일으킬 수 있기 때문에, 교육의 전환transition시기에 특히 두드러졌습니다. 조절초점 이론은 이러한 중요한 시기에 긍정적인 피드백을 받으면 학습자가 스스로 설정 한 목표에 계속 접근하도록 동기를 부여한다고 말한다. 실제로, 우리는 이러한 상황에서 성취초점과 영향력있는 긍정적인 피드백 사이의 연결을 뒷받침하는 많은 사례를 발견했습니다.

Promotion focus seemed particularly prominent at times of transition in training, perhaps because transitions inspire new goals and aspirations in learners. Regulatory focus theory would suggest that well-timed positive feedback received at these critical junctures would motivate learners to continue to approach the goals they set for themselves and, indeed, we found a number of instances supporting the link between promotion focus and influential positive feedback in this context.

다른 참가자는 독립 진료independent practice으로의 전환이 다가옴에 따라, 레지던트 수련 종료에 대한 긍정적 인 피드백을 받았다고 회상했다.

another participant recalled being given valuable positive feedback toward the end of residency training as the transition to independent practice approached:

학습자의 접근 방식이 조정이나 수정을 요구하지 않는다는 감독자의 긍정적 피드백은 동기 부여와 자신감 향상을 떠올리게 했다. 이러한 경우에, 그러한 성과를 통해 의사로서의 정체성을 구축하고, 목표에 도달하거나 보상에 초점을 맞추면서 성취promotion에 중점을 둡니다.

the positive feedback from a supervisor that the learner’s approach required neither adjustment nor correction is recalled as motivating and confidence-enhancing. Educational experiences like these examples, in which the outcome involves building an identity as a doctor, speak to promotion focus, with its emphasis on approaching goals or rewards.

예방초점

Prevention focus

아마도 예방에 초점을 맞춘 작업 중 가장 분명한 예는 실수 방지가 중요한 중대한 시험을 준비하는 것입니다. 조절초점 이론에 의해 예측 된 바와 같이, 참가자들은 이 상황에서 긍정적 피드백의 부정적인 측면을 기술하는 경향이있었습니다.

Perhaps the clearest example of a prevention-focused task is the preparation for high-stakes examinations, in which error avoidance is critical. As would be predicted by regulatory focus theory, participants tended to describe valuing negative over positive feedback in this situation.

실수 방지가 중요한 상황에서 부정적 피드백은 수용가능할 뿐만 아니라 바람직한 것이었으며, 이것이 긍정적 피드백보다 더 가치가 있다는 명백한 합의가있는 것으로 보인다.

there seems to have been an explicit agreement among the players that negative feedback was not only acceptable but desirable, and more highly valued than positive feedback.

부정적 피드백은 기술 훈련 영역에도 영향을 미쳤으며,

Negative feedback was also influential in the realm of skills training,

부정적인 피드백에 대한 긍정적 반응은 이 과제가 예방 중심적 성격을 가진다는 점에 의해 설명 될 수 있습니다. 이것은 "하고 싶은" 과제가 아니라 "해야 하는" 과제입니다.

The responsiveness to negative feedback may be explained by the primarily prevention-focused nature of this particular task: it is a task one must do rather than a task one aspires to do.

비슷한 예가 정확성, 안전성 및 오류 예방에 주로 중점을 두는 외과 기술 교육 분야에서 나타났습니다. 한 참가자는 일상적으로 무뚝뚝한 비판을하는 외과 의사와 함께 일하는 도전적인 경험을 상기하면서 다음과 같이 인정했다. '때로는 그들의 의견이 진정 가혹하고 잔인함에도 불구하고 나의 기술 능력을 향상 시켰습니다.'(P19).

Similar examples appeared in the realm of surgical skills training, with its prevention focus-activating emphasis on accuracy, safety and error prevention. One participant, recalling the challenging experience of working with a surgeon who routinely offered blunt criticism, admitted: ‘Sometimes their feedback, even though it was really harsh and cruel, did improve my technical skills’ (P19).

예방 중심에서 긍정적 인 피드백을 받으면 노력이 줄어들 것입니다.

positive feedback received in prevention focus would result in diminished effort.

상급 연수생에게는 절개를 닫는 것이 일상적이므로, 예방초점이 되기 쉽고, 긍정적인 피드백은 무의미해진다. 그러나 의대생이나 주니어 레지던트는 동일한 과제를 수행하더라도 외과적 경력의 첫 번째 중요한 단계를 나타내기 때문에 성취에 초점을 둘 수 있으며, 따라서 긍정적인 피드백이 매우 중요시될 수도 있습니다. 개별 및 상황 요인과 관련된 잠재적 인 가변성은 피드백에 대한 개별 반응의 예측에 규제 초점 이론을 쉽게 적용하는 데있어 핵심 과제이며 다음 절에서보다 자세히 논의 될 것입니다.

The act of closing skin is routine for a senior trainee and is likely to inspire a prevention focus, which may explain the meaninglessness of positive feedback. One might speculate that the same task, performed by a medical student or junior resident, might involve a promotion focus as it might represent the first important step in a surgical career, in which case positive feedback might have been highly valued. The potential variability in focus related to individual and situational factors is a key challenge in readily applying regulatory focus theory to the prediction of individual responses to feedback and will be discussed in more detail in the following section.

조절초점이론 적용의 어려움

Challenges in applying regulatory focus theory

혼재된 조절초점

Mixed regulatory focus

커리어 결정이나 고부담 시험 준비와 같이 특정 조절초점을 활성화시키는 상황과는 달리, 임상 학습 환경의 많은 작업은 촉진과 예방 모두에 중점을 두어 본질적으로 분류하기가 쉽지 않습니다.

Unlike contexts such as career decision making or preparation for high-stakes examinations, which preferentially activate a particular regulatory focus, many tasks in the clinical learning environment are difficult to readily classify as intrinsically inspiring either a promotion or a prevention focus.

예를 들면, 정맥 주사를 놓는 것은 예방에 중점을 두는 과제의 특성 인 안전성이 중요하고 오류를 피하는 일상적인 기술입니다. 그러나 의대생에게 있어서, 정맥 주사를 놓는 행위는 의사의 전문적 정체성을 갖게 되는 중요한 단계를 상징 할 수 있으며, 이러한 관점에서 성취초점을 활성화합니다. 감독 레지던트의 의견은 그저 교육적으로 보일지 모르지만, 학생에게서 다시 그 과제를 넘겨받아서 자신이 하기보다는, 학생이 할 수 있도록 격려하는 방식으로 학습자의 과제 수행 능력에 대해 자신감을 보여주는 것은 긍정적 인 피드백의 강력한 형태로 인식되었습니다.

In one sense, placing an intravenous line is a routine technical skill in which safety is paramount and errors are to be avoided, both of which are characteristics of a task that inspires prevention focus. However, for a medical student, the act of placing an intravenous line may symbolise a significant step toward assuming the professional identity of a doctor and in this light the task activates promotion focus. Although the comments of the supervising resident may seem merely instructional, the confidence he showed in the learner’s ability to perform the task by providing encouragement rather than taking over the task was perceived as a powerful form of positive feedback.

많은 사례에서, 시나리오를 성취 또는 예방 중심으로 해석하려는 우리의 노력은 효과가 없었습니다. 그것보다 더 적합한 것은 성취와 예방 초점이 하나의 경험 안에서 공존한다는 것이었다.

In many instances, our efforts to interpret scenarios as either promotion or prevention-focused proved fruitless; a more satisfactory interpretation was that promotion and prevention foci coexisted within the same experience.

"나쁜 소식 전하기"는 직업과 관련된 책임이라는 의미에서 예방에 초점을 맞추고 있습니다. 그것은 의사가해야하는 일입니다. 그러나 소아과 의사가 되고자 하는 학생이 있다면, 이 어려운 과제는 사실 스스로 잘 해내고 싶어하는 일이기 때문에 본질적으로 성취 초점을 갖는다. 두 초점의 균형은 개인과 상황 내에서 변화할 수도 있지만 두 초점의 요소가 동시에 존재하는 경우도 있는 것처럼 보입니다.

The task is prevention-focused in the sense that breaking such dreadful news is a responsibility associated with the job; it is something the doctor must do. For an aspiring paediatrician, however, this most difficult of tasks is something one wants to be able to do well and thus it also carries an intrinsic promotion focus. The balance of the two foci may shift within individuals and contexts, but elements of both foci often appear to exist simultaneously.

조절초점이 언제나 업무나 개인의 안정된 특성인 것은 아니었습니다. 예를 들어, 한 참가자는 프레젠테이션 중 실수로 인해 가혹하게 비판을 받았으며, 이 부정적인 피드백의 경험으로 인해 가능한 한 빨리 다시 발표 할 동기가 생겼습니다.

regulatory focus was not always a stable trait of tasks or individuals. One participant, for example, he was harshly criticised for an error he made during his presentation and the experience of this negative feedback strongly motivated him to present again as soon as possible:

동일한 개인 내에서도, 또는 동일한 업무 내에서도 지배적인 조절 초점은 하나의 경우에는 예방이 되고 다른 경우에는 성취가 된다. 컨텍스트와 환경은 항상 예측할 수없는 방식으로 포커스에 영향을 미친다

Both the individual and the task were the same in these two examples, but it is likely that the dominant regulatory focus was prevention in the first instance and promotion in the second. Context and circumstances may conspire to influence focus in ways that are not always predictable.

시간에 따른 초점의 변화

Changes in focus over time

한 명의 개인이 성취초점과 예방초점을 모두 가질 수 있고, 하나의 과제에도 작업에 두 가지 요소가 포함될 수 있다면, 조절초점이 시간 경과에 따라 변할 수도 있습니다. 시간이 지남에 따라 규제 초점을 재구성 한 결과 초기에는 의심스러운 것으로 보이는 의견이 영향력을 발휘했습니다.

If individuals can operate in both promotion and prevention foci, and if tasks can contain elements of both, it seems likely that regulatory focus could also change over time. As a result of this reframing of regulatory focus over time, feedback that had been initially viewed with suspicion became influential.

시간이 흐름에 따라 초반에는 상처가 되고 동기를 저해하는 피드백도 받아들일 수 있게 되었다. 그렇다면 피드백이 재검토되고 유용하다고 판명 된 이유는 무엇입니까? 아마도 이 참여자는 부정적인 피드백의 감정적 인 측면을 처리 할 시간이 필요했을 것이며, 시간이 지남에 따라 성취중심에서 예방중심 활동으로 학업 (프로젝트 완료)을 재구성 할 수 있었을 가능성이 있습니다 .

The passage of time allowed feedback that was initially hurtful and discouraging to become motivating. What changed to allow the feedback to be reconsidered and found to be useful? Perhaps this participant had simply needed time to process the emotional aspect of the negative feedback, but it is also possible that, with time, she was able to reframe her academic work (completing projects) from a promotion-focused to a prevention-focused activity.

피드백 반응에 대한 다른 영향들

Other influences on responsiveness to feedback

우리의 데이터는 규제 초점 이외의 추가 요소가 학습자가 피드백을 해석하는 방법에 영향을 미친다는 사실을 알았습니다. 가장 주목할만한 것은 피드백의 신뢰성입니다.

Our data suggest that additional factors other than regulatory focus influence how learners interpret feedback, the most notable of which is the credibility of the feedback received.

이전 연구에서 지적했듯이 환자의 피드백은 특별한 신뢰성을 갖는 것으로 보인다.

Feedback from patients seems to have particular credibility, as we noted in a previous study.13

고찰

DISCUSSION

우리의 결과는 피드백에 대한 학습자 반응의 복잡성을 보여줍니다.

Our results illustrate the complexity of learner responses to feedback.

히긴스 (Higgins)가 창안 한 이래, 조절초점 이론이 기업가 정신에서부터 스포츠 성과에 대한 설득력있는 논증에 이르기까지 다양한 환경에서 인간의 동기와 행동을 더 잘 이해하기 위해 사용되어왔다 .16-18 그러나 조절초점 이론의 적용 가능성을 조사한 연구는 심리학 연구소의 신중하게 통제 된 세계에서 주로 발생했습니다. '현장 연구'를 넘어 현실적인 직장 환경에서의 태도와 행동에 규제가 미치는 영향을 연구해야 할 필요성이이 분야의 주요 연구자들에 의해 인식되었습니다.

Since its conception by Higgins,10 regulatory focus theory has been used to better understand human motivation and behaviour in a variety of settings, ranging from entrepreneurship to persuasive argument to sporting performance.16–18 However, research examining the applicability of regulatory focus theory has occurred primarily in the carefully controlled world of the psychology laboratory. The need to move beyond ‘scenario studies’ and explore the effect of regulatory focus on attitudes and behaviours in real workplace settings has been recognised by key researchers in this field.19

조절 초점과 피드백에 대한 많은 실험 작업의 문제점은 작업 유형task type이 조절초점의 중재자이자 피드백 효과의 주요 조정자라는 개념에 기반한다는 것입니다. 특정 작업은 성취초점을 활성화하는 반면, 다른 작업은 예방초점을 활성화합니다 . 이 가정은 특정 초점은 특정 작업과 안정되게 연결되어 있음을 함의하는데, 실제 세계에서는 사실 그렇지 않을 가능성도 있다.

A problem with much of the experimental work on regulatory focus and feedback is that it is based on the notion that task type is a key moderator of regulatory focus and thus of feedback effect; certain tasks activate a promotion focus, whereas others activate a prevention focus.12 This assumption implies a certain stability of focus linked to particular tasks which may not be present in real circumstances.

실제로 우리의 핵심 challange는 임상 학습자가 직면하는 많은 과제가 성취 또는 예방 초점 과제 중 하나로만 분류되지 못하는 것이 었습니다. Kluger와 van Dijk9는 '의료진은 예방과 진료의 병목이 혼합되어있다'고 인정하면서도, 의료계는 성취(창의력, 혁신) 대신 예방(오류 회피, 안전)을 강조하는 것처럼 보인다고 추정했다. 그러나 우리의 데이터는 medical learner가 한 가지 초점만 강조하는 경향이 있다고 제안하지 않습니다. 실제로, 종종 동일한 작업 내에 두 가지 초점이 모두 포함되었습니다.

Our key challenge, in fact, was that many of the tasks that face clinical learners defy tidy classification as either promotion or prevention-focused tasks. Although Kluger and van Dijk9 acknowledged that ‘medical staff are faced with a mix of prevention and promotion foci’, they went on to speculate that the medical community seemed to emphasise prevention (error avoidance, safety) over promotion (creativity, innovation). Our data do not suggest, however, that medical learners are inclined to emphasise one focus over the other. Indeed, both foci were often embedded within the same task

우리의 데이터에 따르면 medical learner는 여러가지 서로 다른 과제에 의해 활성화 된 여러 가지 초점에 동시에 대응해야 할뿐만 아니라, 동일한 과제에 의해서도 여러 가지 초점이 활성화될 수 있어서 온갖 종류의 피드백을 주고받게 된다. 이 섬세한 균형은 임상 과제의 독특한 특징 일 수 있습니다. 왜냐하면 임상에서는 종종 이타적인 목표(성취 초점)을 실천하는 동시에 규칙과 절차를 따르는 것(예방 초점)을 추구하기 때문이다. 보다 광범위하게 보자면, 동일한 과제 내에서 초점이 혼합된 것은 교육 환경의 일반적인 특징 일 수 있으며, 이 상황에서 학생들에게 과제의 성공적인 성취는 큰 커리어 목표를 성취하기위한 수단이 된다. 그리고 이것은 학생들이 과제를 안전하고 책임있게 수행하기 위해 노력하는 경우에도 마찬가지입니다.

Our data suggest not only that medical learners must cope simultaneously with different foci activated by different tasks, but also with different foci activated by the same task, which makes the giving and receiving of feedback especially fraught. This delicate balance may be a particular feature of clinical tasks, which often involve following rules and procedures (prevention focus) in the service of altruistic goals (promotion focus). More broadly, this blending of foci around the same task may be a feature of educational settings in general, in which students may view the successful accomplishment of tasks as a means of accomplishing larger career goals, even as they strive to achieve the safe and responsible performance of these tasks.

그러나 우리의 사례 중 일부는 교정 또는 비판적 피드백이 수혜자에 의해 긍정적 인 것으로 여길 수 있음을 보여 주며, 특히 시간이 흐르면서 학습자가 비판적 피드백의 유익한 효과를 인정하게 되는 경우에 그러하다.

Some of our examples, however, demonstrate that feedback that is corrective or critical may be viewed by the recipient as positive, particularly with the passage of time, if he or she is able to appreciate its beneficial effect.

학습자는 관리자로부터받는 피드백에 대한 신뢰도를 매우 비판적으로 평가하며,이 신뢰도 판단에서 생존하는 피드백 만 학습을 형성하는 데 유용 할 수 있습니다 .13 피드백의 신뢰성이 부족하다면, 피드백을 조절초점과 맞추는 것 만으로 그 효과를 보장하기에 충분하지 않습니다. 마찬가지로, 신뢰할만한 피드백은 규제 초점과 피드백 sign 사이의 명백한 불일치가 존재하더라도, 그것을 넘어서서 학습자와 공감할 수 있습니다.

Learners assess the credibility of the feedback they receive from their supervisors very critically, and only feedback that survives this credibility judgement is likely to be useful in shaping learning.13 Matching feedback to regulatory focus is unlikely to be sufficient to guarantee its effectiveness if credibility is lacking. Similarly, highly credible feedback might trump an apparent mismatch between regulatory focus and feedback sign and still resonate with a learner.

우리의 연구는 실제 임상 학습 환경에 존재하지만 Brockner와 Higgins가 '시간 역학 (temporal dynamics)'이라고 부르는 실험실 실험에서 빠져있는 또 다른 중요한 특징을 강조합니다. 우리는 많은 사람들에게 피드백에 대한 반응이 시간의 흐름에 따라 변함을 확인했고, 이는 아마도 조절초점의 변화를 암시한다.

Our work highlights another important feature present in real clinical learning environments but absent from laboratory experiments, which Brockner and Higgins19 have termed ‘temporal dynamics’. We found that, for many individuals, responses to feedback changed with the passage of time, possibly suggesting shifts in regulatory focus.

Eva 등은 예를 들어, 시간이 지남에 따라 개발되는 자신감과 경험이 피드백 인식에 영향을 미쳐보다 위협적인 피드백을 받아들이도록 촉진 할 수 있다고 강조했다. Kluger와 van Dijk9는 사실 그들의 연구 결과가 피드백에 대한 초기 반응에 국한 될 수 있음을 인정했다. 이러한 즉각적인 반응은 학습과 행동에 장기적인 측면에서 항상 가장 큰 영향을 미치는 반응이 아닐 수도 있습니다.

Eva et al.5 have highlighted, for example, that the confidence and experience which develop over time may influence perceptions of feedback, possibly facilitating the acceptance of more threatening feedback. Kluger and van Dijk9 acknowledged, in fact, that their findings might be limited to initial reactions to feedback; these immediate responses may not always be the most salient reactions in terms of long-term influences on learning and behaviour.

교육자가 학습자의 조절초점을 제대로 인식하고 있어야, 그 초점에 맞춰 피드백을 제공 할 수 있으며, 그래야 피드백의 영향력이 더 커질 수 있습니다. 이러한 방식으로 피드백의 효과를 높이기 위해 조절초점을 인식하기 위해서는 피드백이 학습자와의 대화가 되어야 하며, 이 때 감독자는 학습자 자신의 수행 능력에 대한 인식뿐만 아니라, 학습자에게 주어진 과제의 의미와 학습자가 그 과제에 접근 한 동기에 대해서도 이야기를 나누어야 한다.

Armed with an awareness of the learner’s regulatory focus, an educator may be more likely to provide feedback that aligns with that focus and is thus more likely to be influential. Using an awareness of regulatory focus to enhance the effectiveness of feedback in this way will require that feedback be treated as a conversation with the learner, in which the supervisor seeks to understand not only the learner’s perception of his or her own performance, but also the meaning of the task to the learner and the motivation with which he or she has approached it.

교육자는 실제 상황에서 조절초점의 역동적 특성을 활용할 수도 있습니다. Cesario 등은 설득의 과학에 조절초점을 적용하며, 누구나 예방과 성취 초점이 모두 prime될 수 있다는 점에 주목하여, 먼저 한 가지 초점에 priming함으로써 설득력있는 논증에 먼저 접근한 뒤, 그에 맞춰서 메시지를 전달하는 법을 언급했다. 이와 동일한 논리를 피드백 전달에 적용한다면, 필요한 피드백을 수용하는데 도움이되는 방식으로 작업이나 경험을 프레임화할 수 있습니다.

Educators might also use the dynamic nature of regulatory focus in real settings to advantage. Applying regulatory focus to the science of persuasion, Cesario et al.17 noted that both prevention and promotion foci can be primed in all people, making it possible to approach a persuasive argument by first priming one or other focus and then framing a message in a way that fits. Applying this same logic to feedback delivery, educators may frame tasks or experiences in ways that help necessary feedback to be received.

예를 들어, 교육자는 환자의 합병증을 최소화할 의사의 책임을 강조함으로써, 예방 포커스를 활성화하고, 학습자가 비판을 보다 원활하게 수용하도록 가능성을 높일 수 있습니다. 마지막으로, 학습자가 임상 실적에 대한 피드백을받을 때, 스스로의 조절초점을 성찰해보도록 장려하는 것은 학습자의 피드백 수용력을 키울 수 있는 중요하면서도 도전적인 목표를 달성하기위한 생산적인 단계 일 수 있습니다.

An educator might, for example, highlight a surgeon’s responsibility to minimise patient complications as a prelude to providing feedback on a surgical learner’s technique, activating a prevention focus and increasing the likelihood that the learner will be receptive to criticism. Finally, encouraging learners to reflect on their regulatory focus as they receive feedback on clinical performance may be a productive step toward achieving the important but challenging goal of nurturing learners’ receptivity to feedback.

CONCLUSIONS

조절초점 이론은 학습자가 실제 임상 환경에서 피드백에 어떻게 반응 할 것인지를 예측하는 간단한 루브릭을 제공하지 않는다. 이렇게 복잡한 이유는 신뢰도, 피드백에 대한 수용성, 임상 학습 환경을 구성하는 과제의 성격 등과 같은 다양한 요인 때문이며, 여기에는 성취 초점과 예방 초점이 얽혀 있고, 학습자의 관심을 두고 서로 경쟁하기 때문이다.

What regulatory focus theory does not offer is a simple rubric for predicting how learners will react to feedback in real clinical settings. The reasons for this complexity include both the important influences of other factors, such as credibility, on receptivity to feedback, and the nature of the tasks that comprise the clinical learning environment, in which promotion and prevention foci are often inextricably intertwined and may compete for learner attention.

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Med Educ. 2012 Jun;46(6):593-603. doi: 10.1111/j.1365-2923.2012.04209.x.

Understanding responses to feedback: the potential and limitations of regulatory focus theory.

Watling C1, Driessen E, van der Vleuten CP, Vanstone M, Lingard L.

Author information

1

Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada. chris.watling@schulich.uwo.ca

Abstract

OBJECTIVES:

Regulatory focus theory posits the existence of two systems of self-regulation underlying human motivation: promotion focus, which is concerned with aspirations and accomplishments, and prevention focus, which is concerned with obligations and responsibilities. It has been proposed that regulatory focus theory may help to explain learners' variable responses to feedback, predicting that positive feedback is motivating under promotion focus, whereas negative feedback is motivating under prevention focus. We aimed to explore this link between regulatory focus theory and response to feedback using data collected in a naturalistic setting.

METHODS:

In a constructivist grounded theory study, we interviewed 22 early-career academic doctors about experiences they perceived as influential in their learning. Although feedback emerged as important, responses to feedback were highly variable. To better understand how feedback becomes (or fails to become) influential, we used the theoretical framework of regulatory focus to re-examine all descriptions of experiences of receiving and responding to feedback.

RESULTS:

Feedback could be influential or non-influential, regardless of its sign (positive or negative). In circumstances in which the individual's regulatory focus was readily determined, such as in choosing a career (promotion) or preparing for a high-stakes examination (prevention), the apparent influence of feedback was consistent with the prediction of regulatory focus theory. However, we encountered many challenges in applying regulatory focus theory to real feedback scenarios, including the frequent presence of a mixed regulatory focus, the potential for regulatory focus to change over time, and the competing influences of other factors, such as the perceived credibility of the source or content of the feedback.

CONCLUSIONS:

Regulatory focus theory offers a useful, if limited, construct for exploring learners' responses to feedback in the clinical setting. The insights and predictions it offers must be considered in light of the motivational complexity of clinical learning tasks and of other factors influencing the impact of feedback.

© Blackwell Publishing Ltd 2012.

Comment in

• Feedback: the complexity of self-perception and the transition from 'transmit' to 'received and understood'. [Med Educ. 2012]

PMID:

 

22626051

 

DOI:

 

10.1111/j.1365-2923.2012.04209.x