Study 1: Evolving Perceived Value of Feedback: Impact on Medical Communication during Simulated Patient Consultations

The aim was to understand how the value of feedback evolves as communication skills develop. • Design: Qualitative longitudinal design. • Participants: 10 international first-year medical students (1 male, 9 female; mean age 21). • Procedure: o Students completed four SPCs (each followed by feedback and a tutorial discussion). o Data collected via:  Closed questions on ranking feedback sources (student buddies, simulated patients, video annotations, tutorial discussions).  Observation notes from SPCs and tutorials.  Semi-structured interviews (documenting emotions, reactions, and reflections). o Data analysis: Inductive thematic analysis following Braun & Clarke, triangulated with observation notes.

Key Findings: 1. Ranking of feedback sources over four SPCs: o SPC1: Simulated patient feedback ranked highest. o SPC2: Student-buddy feedback most valued. o SPC3: Student-buddy feedback still top, but tutorial discussions gained importance. o SPC4: Tutorial discussions became the most trusted source of feedback. 2. Four explanatory themes for evolving feedback preferences: o Struggling with stress– Early SPCs were stressful; peer feedback helped with coping strategies. o Adapting to the challenge – With experience, students shifted from patient-centered feedback to peer and tutorial insights. o Enhancing learning efficiency – Tutorial discussions reduced extraneous cognitive load by clarifying procedures and prioritizing focus. o Listening to the full story – Over time, students emphasized empathy, authenticity, and hearing the patient’s narrative. 3.