Emotion as Reflexive Practice: A new discourse for feedback practice and research

Introduction

Like medicine and healthcare, feedback is a practice imbued with emotions: saturated with feelings relevant to one’s identity and status within a given context. Often this emotional dimension of feedback is cast as an impediment to be ignored or managed. Such a perspective can be detrimental to feedback practices as emotions are fundamentally entwined with learning. In this critical review we ask: what are the discourses of emotion in the feedback literature and what ‘work’ do they do?

Methods

We conducted a critical literature review of emotion and feedback in the three top journals of the field: Academic Medicine, Medical Education, and Advances in Health Sciences Education. Analysis was informed by a Foucauldian critical discourse approach and involved identifying discourses of emotion and interpreting how they shape feedback practices.

Findings

Of 32 papers, four overlapping discourses of emotion were identified. Emotion as physiological, casts emotion as internal, biological, ever-present, immutable, and often problematic. Emotion as skill positions emotion as internal, mainly cognitive, and amenable to regulation. A discourse of emotion as reflexive practice infers a social and interpersonal understanding of emotions, while emotion as socio-cultural discourse extends the reflexive practice discourse seeing emotion as circulating within learning environments as a political force.

Discussion

Drawing on scholarship within the sociology of emotions, we suggest the merits of studying emotion as inevitable (not pathological), as potentially paralysing and motivating, and as situated within (and often reinforcing) a hierarchical social healthcare landscape. For future feedback research, we suggest shifting towards recognising the discourse-theory-practice connection with emotion in health professional education drawing from reflexive and socio-cultural discourses of emotion.

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