FEEDBACK IN CLINICAL LABORATORY INTERNSHIPS: PERCEPTIONS OF PRECEPTORS AND STUDENTS

Abstract

Feedback is widely recognized as a key element for meaningful learning in health education, especially in practice-based contexts. This study aimed to analyze the perceptions of students and preceptors regarding feedback practices in clinical laboratory internships. This is a qualitative, exploratory, and interpretative study conducted in a clinical laboratory of a university hospital. Seventeen participants were included, comprising five students and twelve preceptors. Data were collected through semi-structured interviews and analyzed using content analysis. The results showed that feedback is valued as an essential tool for learning and patient safety, occurring mainly in an immediate and workflow-integrated manner. However, limitations were identified, including lack of systematization, absence of explicit criteria, workload constraints, and hierarchical. Relational aspects such as trust and psychological safety were central to feedback effectiveness, while bidirectionality emerged more as an expectation than a consolidated practice. It is concluded that improving feedback in supervised internships requires institutional strategies integrating pedagogical training, work organization, and structured dialogic spaces to promote more reflective, systematic, and collaborative practices.

Author Biographies

Rosinete Guedes Carvalho de Miranda, Universidade Federal do Rio Grande do Norte

Farmacêutica da Universidade Federal do Rio Grande do Norte.

Bruno Souza dos Santos, HU BRASIL

Farmacêutico, Mestre em Biotecnologia Industrial e Doutor em Bioquímica.

Simone Nobrega Tomaz Moreira, Universidade Federal do Rio Grande do Norte

Graduação em Ciências Biológicas pela Universidade Federal da Paraíba, Graduação em Psicologia pelo Centro Universitário de João Pessoa, Especialização em Psicologia da Saúde pela Universidade Federal do Rio Grande do Norte, Mestrado e Doutorado em Ciências da Saúde pela Universidade Federal do Rio Grande do Norte. Professora Titular da Universidade Federal do Rio Grande do Norte. Docente efetiva do Mestrado Profissional de Ensino em Saúde MPES/ UFRN. 

Técia Maria de Oliveira Maranhão, Universidade Federal do Rio Grande do Norte

Graduação em Medicina pela Universidade Federal do Rio Grande do Norte (1970), mestrado em Medicina (Obstetrícia e Ginecologia) pela Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (1979) e doutorado em Medicina - Obstetrícia e Ginecologia pela mesma instituição(1982). Aposentou-se como Professora Titular do Departamento de Tocoginecologia da Universidade Federal do Rio Grande do Norte, sendo hoje professora voluntária.

References

1. Ende J. Feedback in clinical medical education. JAMA. 1983;250(6):777–81. DOI: https://doi.org/10.1001/jama.1983.03340060055026

2. Pelgrim EAM, Kramer AWM, Mokkink HGAM, van der Vleuten CPM. The process of feedback in workplace-based assessment: organisation, delivery, continuity. Med Educ. 2012 Jun;46(6):604-12. DOI: https://doi.org/10.1111/j.1365-2923.2012.04266.x

3. Huisman B, Saab N, van den Broek P, van Driel J. The impact of formative peer feedback on higher education students' academic writing: a meta-analysis. Assess Eval High Educ. 2019;44(6):863-80. DOI: https://doi.org/10.1080/02602938.2018.1545896

4. Nesbit PL. The role of self-reflection, emotional management of feedback, and self-regulation processes in self-directed leadership development. Hum Resour Dev Rev. 2012;11(2):203–26. DOI: https://doi.org/10.1177/1534484312439196

5. Van Heerden C, Hawley M, Jayawardena N, Gray A. Perceptions of feedback up to senior doctors and nurses in a tertiary paediatric hospital: a mixed-methods study. Focus Health Prof Educ. 2025;26(1):20-39. DOI: https://doi.org/10.11157/fohpe-vol26iss1id822

6. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. São Paulo: Paz e Terra; 1996.

7. Myers K, Chou CL. Collaborative and bidirectional feedback between students and clinical preceptors: promoting effective communication skills on health care teams. J Midwifery Womens Health. 2016;61(Suppl 1):22-27. DOI: https://doi.org/10.1111/jmwh.12505

8. Contzen Rosende MP. Experiencia de feedback en estudiantes y docentes de pregrado de odontologia [dissertação]. Concepción: Universidad de Concepción; 2017.100f.

9. Benavides C, Nolla M, Ortega J. Retroalimentación y reflexión en estudiantes del ciclo clínico de enfermería: un estudio con aproximación cualitativa. Rev Educ Cienc Salud. 2023;20(2).

10. Valenzuela DI. Capacitación en feedback efectivo para tutores clínicos [Dissertação]. Concepción: Universidad de Concepción; 2021.60f.

11. Buckley S, Coleman J, Davison I, Khan KS, Zamora J, Malick S, et al. The educational effects of portfolios on undergraduate student learning: a Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 11. Med Teach. 2009;31(4):282-98. DOI: https://doi.org/10.1080/01421590902889897

12. Ullah H, Huma S, Yasin G, Ashraf M, Tahir-Ud-Din Q, Shabana H, et al. Curriculum and program evaluation in medical education: a short systematic literature review. Ann Med Surg (Lond). 2024;86(10):5988-94. DOI: https://doi.org/10.1097/MS9.0000000000002518

13. Jug R, Jiang XS, Bean SM. Giving and receiving effective feedback: a review article and how-to guide. Arch Pathol Lab Med. 2019;143(2):244-50. DOI: https://doi.org/10.5858/arpa.2018-0058-RA

14. Henderson M, Ryan T, Phillips M. The challenges of feedback in higher education. Assess Eval High Educ. 2019;44(8):1237–52. DOI: https://doi.org/10.1080/02602938.2019.1599815

15. Watling CJ, Ginsburg S. Assessment, feedback and the alchemy of learning. Med Educ. 2019;53(1):76–85. DOI: https://doi.org/10.1111/medu.13645

16. Ramani S, Könings KD, Ginsburg S, van der Vleuten CPM. Twelve tips to promote a feedback culture with a growth mind-set: swinging the feedback pendulum from recipes to relationships. Med Teach. 2019;41(6):625-31. DOI: https://doi.org/10.1080/0142159X.2018.1432850

17. Soden B. The case of screencast feedback: barriers to the use of learning technology. Innov Pract High Educ. 2017;3(1):1-21.

18. Zeferino AMB, Domingues RCL, Amaral E. Feedback como estratégia de aprendizado no ensino médico. Rev Bras Educ Med. 2007;31(2). DOI: https://doi.org/10.1590/S0100-55022007000200009

19. McCarthy N, Neville K, Pope A. Feedback and formative assessment—looking backwards to move forward. Discov Educ. 2025;4:25. DOI: https://doi.org/10.1007/s44217-025-00414-9

20. Hunukumbure AD, Smith SF, Das S. Holistic feedback approach with video and peer discussion under teacher supervision. BMC Med Educ. 2017;17:179. DOI: https://doi.org/10.1186/s12909-017-1017-x

21. Oliveira VTD, Batista NA. Avaliação formativa em sessão tutorial: concepções e dificuldades. Rev Bras Educ Med. 2012;36(3):374-80. DOI: https://doi.org/10.1590/S0100-55022012000500012

22. Stagini S, Peres LVC. Percepções de docentes e discentes sobre feedback em estágios práticos no curso de medicina. Rev Bras Educ Med. 2021;45(3). DOI: https://doi.org/10.1590/1981-5271v45.3-20200444

23. Natesan S, Jordan J, Sheng A, Carmelli G, Barbas B, King A, et al. Feedback in medical education: an evidence-based guide to best practices from the Council of Residency Directors in Emergency Medicine. West J Emerg Med. 2023;24(3):479-94. DOI: https://doi.org/10.5811/WESTJEM.56544

24. Spickard A 3rd, Gigante J, Stein G, Denny JC. Automatic capture of student notes to augment mentor feedback and student performance on patient write-ups. J Gen Intern Med. 2008 Jul;23(7):979-84. DOI: https://doi.org/10.1007/s11606-008-0608-y

25. Engerer C, Berberat PO, Dinkel A, Rudolph B, Sattel H, Wuensch A. Specific feedback makes medical students better communicators. BMC Med Educ. 2019 Feb 8;19(1):51. DOI: https://doi.org/10.1186/s12909-019-1470-9

26. Hattie J, Timperley H. The power of feedback. Rev Educ Res. 2007;77(1):81–112. DOI: https://doi.org/10.3102/003465430298487

27. Krackov SK. Giving feedback. In: Dent JA, Harden RM, editors. A practical guide for medical teachers. 3. ed. London: Churchill Livingstone Elsevier; 2009.

28. Mulliner E, Tucker M. Feedback on feedback practice: perceptions of students and academics. Assess Eval High Educ. 2017;42(2):266-88. DOI: https://doi.org/10.1080/02602938.2015.1103365

29. Boud D, Molloy E. Rethinking models of feedback for learning: the challenge of design. Assess Eval High Educ. 2013;38(6):698-712. DOI: https://doi.org/10.1080/02602938.2012.691462

30. Molloy E, Ajjawi R, Bearman M, Noble C, Rudland J, Ryan A. Challenging feedback myths: values, learner involvement and promoting effects beyond the immediate task. Med Educ. 2020;54(1):33-9. DOI: https://doi.org/10.1111/medu.13802

31. Dohrenwend A. Serving up the feedback sandwich. Fam Pract Manag. 2002;9(10):43-49.

32. Carless D, Boud D. The development of student feedback literacy: enabling uptake of feedback. Assess Eval High Educ. 2018;43(8):1315-25. DOI: https://doi.org/10.1080/02602938.2018.1463354

33. Nicol D, Thomson A, Breslin C. Rethinking feedback practices in higher education: a peer review perspective. Assess Eval High Educ. 2014;39(1):102-22. DOI: https://doi.org/10.1080/02602938.2013.795518

34. Milan FB, Parish SJ, Reichgott MJ. A model for educational feedback based on clinical communication skills strategies: beyond the "feedback sandwich". Teach Learn Med. 2006;18(1):42-7. DOI: https://doi.org/10.1207/s15328015tlm1801_9

35. Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 15. ed. São Paulo: Hucitec; 2025.

36. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57. DOI: https://doi.org/10.1093/intqhc/mzm042

37. Bardin L. Análise de conteúdo. 3. ed. Lisboa: Edições 70; 2004.

38. Patton MQ. Qualitative research & evaluation methods: integrating theory and practice. 4. ed. Los Angeles: Sage; 2015.

39. Fontanella BJB, Luchesi BM, Saidel MGB, Ricas J, Turato ER, Melo DG. Amostragem em pesquisas qualitativas: proposta de procedimentos para constatar saturação teórica. Cad Saude Publica. 2011 Feb;27(2):388-94. DOI: https://doi.org/10.1590/S0102-311X2011000200020

40. Lüdke M, André MEDA. Pesquisa em educação: abordagens qualitativas. São Paulo: EPU; 2013.

41. Lincoln YS, Guba EG. Naturalistic inquiry. Beverly Hills (CA): Sage; 1985. DOI: https://doi.org/10.1016/0147-1767(85)90062-8

42. Sadler DR. Beyond feedback: developing student capability in complex appraisal. In: Approaches to assessment that enhance learning in higher education. 1st ed. London: Routledge; 2012. p. 45-60.

43. Yu H, Li Z, Köhler SE, van Merriënboer JJG, Asoodar M. How medical students make sense of feedback. BMC Med Educ. 2025;25(1):256. DOI: https://doi.org/10.1186/s12909-025-06845-0

44. Hussain A, Kakakhel MM, Ashraf MF, Shahab M, Ahmad F, Luqman F, et al. Innovative approaches to safe surgery: a narrative synthesis of best practices. Cureus. 2023; 15(11). DOI: https://doi.org/10.7759/cureus.49723

45. Roh H, Park SJ, Kim T. Patient safety education to change medical students' attitudes and sense of responsibility. Med Teach. 2015;37(10):908-14. DOI: https://doi.org/10.3109/0142159X.2014.970988

46. Donkin R, Askew E, Stevenson H. Video feedback and e-learning enhances laboratory skills and engagement in medical laboratory science students. BMC Med Educ. 2019;19:310. DOI: https://doi.org/10.1186/s12909-019-1745-1

47. Davis SP. Facilitators of and barriers to effective preceptorships for pre-licensure nursing students: what nursing faculty need to know. SAGE Open Nursing. 2024;10. DOI: https://doi.org/10.1177/23779608241279148

How to Cite

Guedes Carvalho de Miranda, R., Souza dos Santos, B., Nobrega Tomaz Moreira, S., & Maria de Oliveira Maranhão, T. (2026). FEEDBACK IN CLINICAL LABORATORY INTERNSHIPS: PERCEPTIONS OF PRECEPTORS AND STUDENTS. RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 7(6), e768059. https://doi.org/10.47820/recima21.v7i6.8059