Is There Feedback Fatigue? Medical Teachers' Views on Cognitive and Affective Factors in Providing Written Feedback

Feedback is a powerful learning tool. Despite its importance, literature has demonstrated how provision of written feedback is often frustrating for medical teachers, some of which are due to time constraint and students’ inadequate responses towards feedback. Therefore, this study argues that providing written feedback is not only a cognitive process, but also heavily relies on teachers’ emotions. This study aims to explore factors that cognitively and affectively influence the provision of written feedback in medical education. This was a descriptive qualitative study involving 33 medical teachers distributed into four focus groups (FGs). FGs were conducted using an interview guide developed from the literature focusing on teachers’ perceptions on written feedback. Data were transcribed verbatim and analysed using a thematic analysis approach. Four affecting components in providing written feedback were identified consisting of teachers’ cognitive and affective elements during observation and interpretation process, students’ characteristics and the nature of the task, significance of feedback, and institutional feedback culture and policies. Besides the teachers’ individual elements, all other three components also affected teachers’ cognitive and affective processes, which further influenced the delivery of written feedback. Some teachers perceived increased cognitive load when they had to write feedback, and some emotional dilemmas between wanting to give written feedback but feeling fatigue. Written feedback was considered useful for documentation, however there were concerns over misinterpretation which may discourage teachers from providing it. Providing written feedback is proven to be a complex process, involving not only cognitive but also affective factors. Supporting teachers’ roles in giving written feedback requires attention to a wide range of factors, from teachers self-regulating ability to the institutional policies on feedback provision.