Lecturers from the School of Health Sciences have drawn on their own experience to compile a list of options to support clinical formative assessment and feedback, along with benefits, challenges and alternative suggestions.

Clinical competencies with feedback

Pros	Cons	Alternative suggestions
High quality feedback  Individual or groups  Identification of students who need additional support	Costly  Staff intensive  Room availability	Use clinical skills facilities, where possible  Maximise number of students seen in a visit  Train small number of clinical staff to undertake this role. Moderate feedback / rotate visits

Clinical portfolio review

Pros	Cons	Alternative suggestions
Developmental   Student led  Practice educator &/or academic can review and provide feedback  Highlights areas that need development / additional experience	Time consuming for students and academic staff / PE  Does not always reflect true progress	Consider on-line portfolio  Use of templates &/or rubrics

Clinical supervisor / practice educator feedback reports 

Pros	Cons	Alternative suggestions
Feedback from someone working with the student on placement  Liaison with clinical placement & HEI	Can lack consistency across a cohort  Variable skills & experience of PE.  May not always identify students who need additional support.	Ensure clinical supervisor/ PE is fully trained and supported in the role, to provide constructive, timely feedback.

Clinical visits

Pros	Cons	Alternative suggestions
High quality feedback  Individual or groups  Identification of students who need additional support	Costly  Staff intensive  Room availability	Use clinical skills facilities, where possible  Maximise number of students seen in a visit  Train small number of clinical staff to undertake this role. Moderate feedback / rotate visits

Formative feedback on clinical skills

Pros	Cons	Alternative suggestions
Could be in the HEI or clinical setting  Can be any trained practice educator (PE)/mentor/practice assessor (PA)/practice supervisor (PS)  Can use video to inform feedback   Feedback from service user /patient/client may be included	Needs to be honest constructive feedback  Useful to have on-going training and support for PE/mentor/ practice assessor (PA)/practice supervisor (PS)  Difficult to plan in clinical settings / may be cancelled due to pressures in clinical setting	Useful to include some formative feedback within university setting or from one PE/mentor/ practice assessor (PA)/practice supervisor (PS) per clinical site, to ensure consistency

Mock OSCEs with academic feedback

Pros	Cons	Alternative suggestions
Assess clinical skills   Monitor team working and ‘soft skills’  Provides immediate feedback  Identification of students who need additional support  Gives students a chance to experience the examination  Identification of common mistakes or unsafe practice  Reinforces safe and effective practice in clinical skills  Gives students an opportunity to reflect on their skills	Staff intensive  Time consuming  Lack of consistency between staff on how to perform a clinical skill (may teach it differently)  Students may not attend if sessions occur outside scheduled timetable hours or when in placement	Develop template feedback / rubrics  Include some specific comments on areas for improvement  Suggest students reflect on feedback and produce summary of 3 points to improve on.

Mock OSEs

Pros	Cons	Alternative suggestions
Gives students a chance to experience the examination  Provides immediate feedback (if go through the answers at the time)  Identification of students who need additional support  May assist student identify their own areas for future learning	Individual feedback / marking can be very time consuming.  May demoralise a student that has performed badly	Go through the feedback in the group

Peer-reviewed OSCE practice

Pros	Cons	Alternative suggestions
Less staff intensive  Gives students ownership / responsibility  Develops team working and other transferable skills   Tests the peer reviewer’s knowledge and skills; they need to know the skill to effectively peer review the other student.	Can spread poor practice if students are unsure of the correct procedure.  Not always going to  identify students who need additional support  May not get constructive feedback	Teach students how to give constructive, supportive feedback  Identify peers to engage in peer to peer learning & fully support them in the role   Use examples to ensure understanding of criteria for feedback  Challenge students to explain their rationale for feedback provided  Possibly consider use of anonymous peer feedback rubrics / assessment feedback forms

Peer-to-peer learning in skills suite

E.g. more experienced students teach newer students &/or pilot co-pilot model

Pros	Cons	Alternative suggestions
Gives students ownership  Develops team working and other transferable skills  Less staff intensive   Can give students a wider range of feedback than simply from staff  May help students’ awareness of standard for assessment, which could help in their own work	Can spread poor practice if students are unsure of the correct procedure.  Not always going to  identify students who need additional support  May not get constructive feedback	Consider having some peer to peer learning with academic or clinical staff input and review   Possibly get the students to video activities to review later in groups with a facilitator

Role play with debrief and feedback

Pros	Cons	Alternative suggestions
Assess a wide range of issues   Deal with challenging or unusual scenarios  Provides immediate feedback	Students don’t always like role play  Can seem artificial  Time consuming to develop  Staff intensive  Students can find them stressful	Enable students to be the service user, to experience the patient perspective

Self-marking of clinical skills

Pros	Cons	Alternative suggestions
Students reflect on own abilities	May be over critical or overly confident  Lacks objectivity  Probably not going to identify students who need additional support	Consider some elements of self and peer review, in addition to staff input, to allow comparisons between perception and reality.  Consider using film when performing clinical skills and use this as part of the reflective process

Simulation with feedback and reflection

Pros	Cons	Alternative suggestions
Assess a wide range of issues   Deal with challenging or unusual scenarios  Provides immediate feedback  Encourage self-evaluation  Students often like simulation   Allows repetition / revisit difficult areas.  Enact scenarios in ‘real time’   Allows students to take risks, call time out, and make mistakes	Costly if equipment needed  Need to ensure equipment is up to date and reflects what is used in clinical settings  Can be staff intensive  ? room availability  Challenging to create realistic scenarios  Technical skills required to use equipment / manikins / filming / computers	Some forms of simulation can be for ‘soft skills’   Use of ‘experts by experience’ can make the simulation more authentic. Service user feedback can help students evaluate their actions on the service user.  Involvement of students in writing scenarios based on their experiences

Vivas

Pros	Cons	Alternative suggestions
Good way to assess a wide range of issues   Provides immediate feedback  Identification of students who need additional support	Staff intensive  Students can find them stressful	Group viva  Peer viva  Co-create questions for vivas, which can be reviewed by students  Try to use clinical scenarios for viva questions, to ensure link theory to practice.