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01-08-2017 | Original Article | Uitgave 4/2017 Open Access

Perspectives on Medical Education 4/2017

Am I ready for it? Students’ perceptions of meaningful feedback on entrustable professional activities

Perspectives on Medical Education > Uitgave 4/2017
Chantal C. M. A. Duijn, Lisanne S. Welink, Mira Mandoki, Olle T. J. ten Cate, Wim D. J. Kremer, Harold G. J. Bok
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Electronic supplementary material

The online version of this article (doi: 10.​1007/​s40037-017-0361-1) contains supplementary material, which is available to authorized users.



Receiving feedback while in the clinical workplace is probably the most frequently voiced desire of students. In clinical learning environments, providing and seeking performance-relevant information is often difficult for both supervisors and students. The use of entrustable professional activities (EPAs) can help to improve student assessment within competency-based education. This study aimed to illustrate what students’ perceptions are of meaningful feedback viewed as conducive in preparing for performing EPA unsupervised.


In a qualitative multicentre study we explored students’ perceptions on meaningful feedback related to EPAs in the clinical workplace. Focus groups were conducted in three different healthcare institutes. Based on concepts from the literature, the transcripts were coded, iteratively reduced and displayed.


Participants’ preferences regarding meaningful feedback on EPAs were quite similar, irrespective of their institution or type of clerkship. Participants explicitly mentioned that feedback on EPAs could come from a variety of sources. Feedback must come from a credible, trustworthy supervisor who knows the student well, be delivered in a safe environment and stress both strengths and points for improvement. The feedback should be provided immediately after the observed activity and include instructions for follow-up. Students would appreciate feedback that refers to their ability to act unsupervised.


There is abundant literature on how feedback should be provided, and what factors influence how feedback is sought by students. This study showed that students who are training to perform an EPA unsupervised have clear ideas about how, when and from whom feedback should be delivered.
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