Ellaway, RachelPatocka, Catherine2024-07-092024-07-092024-07-03Patocka, C. (2024). The evolution of a pattern language of feedback in medical education (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.https://hdl.handle.net/1880/119132https://doi.org/10.11575/PRISM/46728Feedback is embedded within the fabric of medical education. Although the literature refers to feedback as if it were well-defined, in practice what feedback means can vary greatly. Consequently, it remains a source of consternation for learners and teachers as a process fraught with paradoxes. When done well, feedback can improve performance, however it can also have highly variable outcomes. Through an in-depth examination of feedback, my research has acknowledged the challenges presented by it and other equally polysemic concepts. My research has considered the philosophical, theoretical, and methodological assumptions underpinning our existing approaches to feedback and in response I present a path to a more inclusive approach through the application of pattern theory. To approach the task of applying pattern theory, I adapted scoping review methodology to develop a pattern system of feedback in medical education which includes 36 pattern representations. Through a comparative case study, I applied the pattern system to models of feedback, and I provided validity evidence for the pattern system. By outlining the connections between pattern representations within it, I also began to elaborate the pattern system into a pattern language. Finally, I used a case study research methodology to develop a thick description of the challenges of bringing this novel theory-informed conceptual framing of feedback into a more practical space. In all this work, I have advocated for generative (rather than successionist) models of explanations of feedback and lay the foundations for exploring the intersection of realist inquiry and pattern epistemology. Feedback is used as an illustrative case throughout this thesis. The pattern system of feedback I developed, my documentation of the disjointed discourses of feedback in medical education, and my description of this evolving pattern language of feedback can all serve to advance thinking and theory building in this conceptual space. Furthermore, my use of various methodologies to tackle this polysemic concept is, I will argue, a viable approach for studying other fuzzy concepts in our field. As such, not only can my work provide insights into feedback, but it also provides opportunities to explore other equally vexing problems.enUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.patternrealist inquiryfeedbackEducationMedicine and Surgerydoctoral thesis