Section 5: Types of Student Reactions
Types of Student Reactions to Preceptor Feedback
| Internalizing Student | Externalizing Student | |
|---|---|---|
| Tendencies | Student recognizes their faults and how they contribute to the negative feedback. May already have a good sense of areas that are in need of improvement. | May or may not recognize their own contribution to the feedback that they are receiving. |
| Reaction to negative feedback | Could react with anxiety/panic, tears, anger toward self (that may be experienced by preceptor as anger toward the preceptor), fearfulness regarding consequences of negative feedback. May shut down or have a frozen, "deer in the headlights" reaction. | This student blames external factors, including, but not limited to, the preceptor, the patient, peers, the grading system, and/or the university....This student is unable and/or unwilling to accept feedback. |
| Student Perspective and Interpretation | May have trouble recognizing feedback as appropriate and necessary; may, instead, interpret feedback as their being defective, not having skills that they should have at this point; likely to think of themselves as less prepared or less equipped than peers. Student's response may be exacerbated by preceptors who are shaming, have a harsh tone, or make the feedback personal rather than normalizing it as developmental, belaboring feedback. | The student is likely to be emotionally fragile but may react in a superior manner to the preceptor and feedback. This superior manner may manifest as dismissive and/or angry (confrontational versus conversational). This type of student can be very triggering to preceptors with traditional views of relationships with authority figures. That is, it can be shocking when students react angrily rather than deferential toward an authority figure. |
Maria Armandi, OD and Tami Acril-Davis. Psy. C. 2023 |
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Potential Student Scenarios:
*Not all students are going to fit neatly into these categories. Many situations are complex and fall into multiple categories at the same time.*
- The ‘unmotivated’ student: needs a ‘reality check’
- The ‘confused’ student: seems ‘oblivious’ to why they are receiving your negative feedback)
- The ‘referral’ student: you suspect a Learning Difference, ADHD, or underlying health dx and want to address it with an appropriate referral
- The ‘emotional’ student: angry/crying upon receiving feedback
- The ‘anxious’ student: panics or withdraws or seems to be in despair upon receiving negative feedback
- The ‘dismissive’ student: denies or does not take accountability for the reality of negative feedback; has some components from scenarios of student who is unmotivated, confused and/or emotional
Preceptor Pearl: Open a difficult conversation with “How do you think you’ve been doing clinically so far?” This builds learner critical thinking and helps preceptors ease into providing feedback.
