الفهرس 
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Abstract
During clinical experiences, the provision of feedback forms an integral part of the learning process and enriches students’ learning experiences. The purpose of feedback is to improve the learner’s knowledge, skills and behavior. Receiving of accurate feedback can help to narrow the gap between actual and desired performance. Effective and regular feedback has the potential to reinforce good practice and motivate the learner toward the desired outcome.
Despite the obvious role of feedback in effective clinical teaching and learning, a common complaint from students was that they did not receive focused, comprehensive, clear, adequate, immediate and balanced feedback.
So, the present study aimed to explore nursing students’ perspectives regarding the effectiveness of oral and written feedback during clinical experience.
Materials and methods:
Design: An exploratory descriptive design was used to carry out this study
Setting:
The study was carried out at Faculty of Nursing Damanhour University in clinical settings at eight scientific academic nursing departments, namely: Medical Surgical Nursing, Critical Care and Emergency Nursing, Pediatric Nursing, Obstetric and Gynecological Nursing, Community Health Nursing, Gerontological Nursing, Psychiatric and Mental Health Nursing and Nursing Administration department.
Subjects:
The subjects of this study comprised 287 nursing students who were selected randomly to represent 1140 nursing students. They were exposed to different clinical experiences at different academic years during the academic year 2017-2018, 2nd term.
Tools of the study: In order to collect the necessary data one tool was used.
”Students’ Perspectives Regarding the Effectiveness of Oral and Written Feedback during Clinical Experience Questionnaire”
This tool was developed by the researcher after thorough review of related literature to explore nursing students’ perspectives regarding the effectiveness of oral and written feedback during clinical experience. It consisted of 61 items, which were entitled under 8 dimensions presented as follows: First, relevance of oral and written feedback which included 10 items, second dimension, which included 13 items in relation to comprehensiveness and clarity of oral and written feedback, third, time of providing oral and written feedback which contained 3 items, fourth dimension, which comprised 5 items regarding equality of oral and written feedback given by the teacher, the fifth one, which included 10 items concerning students’ overall feelings about oral and written feedback, sixth, teacher methods in giving oral and written feedback which consisted of 7 items, seventh, legality of written feedback which comprised 4 items, and finally, eighth dimension, regarding responses of students to the oral and written feedback they received which included 9 items.
Three points -Likert -type scale ranged from always occur (3) to never occur (1) was used. The scores ranged between <33. 3% - 100%, which classified into 3 categories, less effectiveness of the feedback for the score <33. 3%, moderate effectiveness for the score ranged from 33. 4% to 66. 6% and high effectiveness for the score ranged from 66. 7-100%.
In addition to demographic and academic data such as; students’ age, sex, academic year, last certificate and scientific department.
This tool was tested for its content validity by a jury of five experts in the field of the study and the necessary modifications were done accordingly. It was also tested for its reliability using Cronbach’s alpha test and was found reliable with a value = 0.906.
A pilot study was carried out on 10 % of the sample (29 students) to assess the clarity and applicability of the study tool .Those participants were excluded from the actual study. The pilot study proved that the study tool was clear and feasible.
Data collection was carried out on nursing students at different academic years in the previous mentioned academic departments during pre and post clinical conferences from the beginning of April 2018 until its end.
Questionnaires were distributed to be answered by students after explaining the study aim and after consents of the students were obtained and confidentiality assured.
The following are the main results of the current study:
Overall, it was observed that oral and written feedback had moderate effectiveness (57.5%, 52.6%).
Regarding students’ perception to the effectiveness of oral and written feedback in the different academic years, concerning first year, it was observed that written feedback was higher effective than oral feedback (58.9%). Regarding second year, moderate effectiveness of written feedback was observed (54.1%). Concerning third year, it was observed that oral feedback had moderate effectiveness (61.3%). Finally, moderate effectiveness of oral feedback (64.8%) was observed at the fourth academic year.
Concerning students’ perspectives regarding relevance of oral and written feedback they receive, about half of the students respectively, reported that oral and written feedback were always given in relation to the task, learning objectives, evaluation items and based upon teacher’s direct observation of their work.
Concerning students’ perception regarding comprehensiveness and clarity of oral and written feedback, about more than half (59.6% and 55.1%) of students stated that feedback always helped them to understand things better in oral and written feedback. Almost equal proportions 40.8% and 42.2% of students found that oral and written feedback always explained lack of their knowledge and understanding. Also, more than half of the students (58.2% and 59.9%) agreed that teacher sometimes did not provide enough oral and written feedback.
Concerning students’ perception regarding the time of providing oral and written feedback, about more than half of students (55.4%, 60.6%, 61% and 62.4%) respectively, stated that teaching staff were sometimes willing to provide feedback and gave feedback immediately after the task.
Regarding students’ perspectives regarding equality of oral and written feedback, more than half of the students (50.5% and 53%) reported that oral and written feedback were sometimes given equally to all students. While, only 26.8% and 26.1% of the students agreed that oral and written feedback were given in a way that some students receive more feedback than the others.
Concerning students’ perception regarding their overall feelings about oral and written feedback, about two-third of the students (61.7% and 64.1%) reported that positive oral and written feedback was always improved their self –confidence. On the other hand about less than half of the students (46.7%, 43.6%, 46%, 43.9%, 45.3% and 44.9%) respectively, sometimes felt that they were demoralized or angry after receiving negative feedback, anxious when they received feedback in front of others and were unsatisfied after receiving negative feedback without suggestions on how to improve.
Regarding students’ perception to teacher’s methods in giving oral and written feedback, about more than half of the students (65.1%, 58.2%, 54% and 55.7%) respectively, reported that teacher sometimes accepted and encouraged their feelings and ideas in a non- threatening manner and gave feedback in a kindly way. On the other hand, minority of them 9.1% and 13.6% reported that teacher gave oral and written feedback in an aggressive way.
Concerning students’ reactions and their responses to oral and written feedback they receive, 43.9%, 46.7%, 48.1% and 52.6% of the students reported that they were always read the feedback carefully and try to understand what the feedback was saying and used oral and written feedback to try and improve their results in future work.
Concerning students’ perception regarding the legality of written feedback they receive, 54.4% of students agreed that written feedback was always written in ink. 53% of them reported that written feedback was sometimes dated. While about only one-quarter of them (14.6% and 13.6%) confirmed that written feedback was not documented and signed.
Finally, there was no significant difference between oral and written feedback where P=0.133.
Based on the research’s findings, the following was concluded:
Conclusion
It can be concluded from the present study that:
Feedback is essential for effective student learning in clinical practice, where it has an influence on their current performance; develop their capability for making judgment about their current work and how to improve their subsequent performance. Oral and written feedback is a valuable learning and evaluative tool as it plays a crucial role in effective clinical teaching and supervision of learners, enhances the teacher-learner relationship and leads to beneficial changes in learners’ behavior.
As well as it helps students to increase their confidence, motivation and self-esteem. It can help students rate their clinical practice in a realistic way. Without feedback, good performance is not reinforced and poor performance may be repeated.
Recommendations
Based on the findings of the present study, the following recommendations are suggested:
Recommendations related to nursing education
• The faculty should conduct educational workshops to all nurse educators to raise their awareness and competences in delivering and receiving feedback effectively.
• The faculty should develop a process for monitoring the feedback process such as videotaping sessions and peer observation with debriefing sessions.
• Developing guidelines as booklets that include different methods about principles of conduction and delivery of feedback effectively.
Recommendations for further studies
• Teachers’ perspectives regarding the effectiveness of feedback.
• A comparative study between using feedback as a formative tool and as an evaluative tool.
• Replicates the study about effectiveness of oral and written feedback in other nursing faculties for more generalization of the results.