A scoping review of peer-reviewed and grey literature on digital/electronic feedback tools in medical clinical education will be conducted. The scoping review will be guided by the Joanna Briggs Institute (JBI) framework through its use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) as a reporting guide for the review [13].
Stage 1: Identifying the research question
The main objective of the review is to consider what the available evidence is with regard to the different digital tools and applications being used to enhance the giving and receiving of feedback in undergraduate and postgraduate clinical training. Underpinning this objective are questions about the constraints and facilitators to developing, implementing, and assessing digital feedback provision tools in medical education.
Based on the objectives of this scoping review, we have developed the following research questions.
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1.
What digital tools and applications are available for giving and receiving feedback in the clinical training environment?
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2.
What are the main functions or features of the digital tools and applications?
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3.
How are the digital tools and applications currently being used for feedback in the clinical training environment?
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4.
What are the barriers and facilitators of using technology to encourage or enhance feedback culture in the clinical environment?
Stage 2: Identifying relevant studies
Peer-reviewed journals will be reviewed for primary studies with a clear empirical base utilising qualitative, quantitative, and mixed methods addressing the research question. An electronic search of the following databases will be conducted: PubMed/MEDLINE, EBSCOhost (academic search complete, CINAHL with full text) Scopus, Google Scholar, Union Catalogue of Theses and Dissertations (UCTD) via SABINET Online and World Cat Dissertations and Theses via OCLC. Studies will be identified by searching literature from January 2010 to date. A manual search through the main published texts used in medical education teaching and practise will also be conducted. In addition, articles will be searched through the “cited by” search as well as citations included in the reference lists of included articles. The search terms will include e-learning, mobile applications, Google Forms, web-based, telemedicine, smartphones, Twitter, feedback in clinical and medical undergraduate and postgraduate training. Boolean terms (AND) will be used to separate the keywords, and Medical Subject Headings (MESH) terms will also be included during the search. The syntax will be modified where needed. Medical education journals will be searched (i.e. Academic Medicine, Advances in Health Sciences Education, BMC Medical Education, Journal of Continuing Education in the Health Professions, Medical Education, Medical Teacher, and Teaching and Learning in Medicine), with the same keywords and date range. Reference lists of selected articles will also be searched for other articles of interest. The services of an experienced subject librarian will be used to ensure that a robust review search strategy is followed. The search strategy will be piloted to check the appropriateness of selected electronic databases and keywords as illustrated in Table 1 (see supplementary material). To compile all relevant evidence sources, identify and remove duplicate records; EndNote X9 reference manager will be used. The review team will search for the evidence sources and import them onto an EndNote library created for this review.
Stage 3: Study selection
Eligibility criteria will be developed to ensure specific information relating to the research question is included in the studies.
Inclusion criteria
For studies to be included, they should meet the following criteria:
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Be available in full text
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Must include medical and/or postgraduate clinical medical education
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Must focus on digital and other forms/modalities/methodologies of electronic feedback
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Since most literature about digital tools for clinical training has been in the recent decade and due to ongoing advances in technology, this review will focus on the latest technologies reported in studies published between January 2010 to date of review.
Exclusion criteria
Studies will be excluded should they as follows:
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Not be available in full text
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Focus on feedback in other fields beyond medical education
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Not include detail of digital technologies used
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Only report on the technical specifications of the feedback tool
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Be outside the identified search period
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Not be available in English
Eligibility criteria
Eligibility criteria for the scoping review will draw from the JBI mnemonic for the formulation of scoping review questions describing the population, concept, and context (PCC) of the study [14].
Population
The scoping review will source all relevant peer-reviewed and grey literature that takes as its objective and the study of development, implementation and assessment of digital feedback provision tools in medical education. The population sample for the review will be undergraduate and postgraduate medical students who participate in the various sourced studies under the review. The rationale for the inclusion of medical students in the study population relates specifically to the importance of their perceptions regarding the use of digital feedback tools in the clinical environment.
Context
The context of the study is in the field of clinical practice in medical education and training; however, geographically, the review will source studies and grey literature from around the world in order to develop a most comprehensive appraisal of the development, implementation and assessment of digital feedback tools in the field of clinical practice amongst undergraduates and postgraduate students in medical education and training. By conducting an expansive search, the review can widen its references in terms of meaningfully categorising the nature and typology of digital feedback provision tools in clinical practice in medical education and training.
Language
The review will source English language studies only.
Date
The date search range for the review will take the period between 2010 and the current review date, which is a period that has seen the most rapid advance in smartphone and digital technologies, with smartphones being described as having been the barometers of change during this period [15]. Not only there has been rapid advancements in the design and use of smartphone digital technologies but also there has also been a rapid increase in terms of accessibility to smartphone devices [16], which because of their sophistication, have been increasingly adopted into clinical practice by healthcare practitioners and medical students in clinical practice [17].
Study designs
All study designs will be considered for the review.
Stage 4: Charting the evidence
An abstract screening tool using Google Forms will be developed and distributed to the review team. Abstract screening, followed by full article screening, will be conducted, including those articles for which an abstract is not available. As illustrated in Table 2 (see supplementary material), a data charting table will be developed and used to extract background information and process the information from each study selected. To ensure that all pertinent information regarding the relevant aspects of the study is collected, the data charting form will first be piloted and then continually updated as required.
Stage 5: Extracting the evidence
A data extraction sheet will be constructed via Microsoft Excel. This tool will be designed and piloted by the authors for the use of data extraction as well as data charting by the reviewers. A primary reviewer will use the data extraction tool in consultation with a second reviewer (CB and RA). Information to be extracted from the extraction tool is provided in Table 2 (see supplementary material). A citation manager will be used to create a library for this review. The primary investigator will conduct a search using the key fields in the databases created. Eligible studies will be exported to the citation manager, and duplicates removed before abstracts are screened by two reviewers. Any disagreement will be mediated by a third independent reviewer (VSS). Full article screening guided by the eligibility criteria will then be carried out independently by the review team. Data collection for the review will be documented using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) flowchart as in Fig. 1.
Stage 6 Collating, summarising and reporting the results
The summarisation and reporting of the data will use a basic descriptive approach [14] in the form of a content analysis [19]. The basic content analysis will categorise the different digital tools and applications currently being used for feedback in clinical training environment into their uses, into their main features and functions, into their typologies, and into the various constraints and facilitators that characterise their development, implementation and assessment.