The reality of uncertainty: Transforming feedback cultures
28 November 2025
In this post, CRADLE Senior Research Fellow Dr Nicole Crawford shares her reflections and key takeaways from our last seminar of 2025. In the seminar CRADLE’s Professor Margaret Bearman presented an insightful and nuanced discussion on the role that feedback cultures play in surgical and intensive care medicine training.
More than the individual: transforming feedback cultures
Many of you might know about CRADLE through its research on assessment and feedback in higher education and, more recently, on generative artificial intelligence. However, a longstanding string to CRADLE’s bow is its research on health professions education. Over many years, CRADLE researchers and collaborators have been endeavouring to improve assessment and feedback in medical education and training.
As part of the 2025 CRADLE Seminar Series, Professor Margaret Bearman recently presented an overview of an epic program of research that she has been leading for the last five years. In the seminar titled ‘More than the individual: transforming feedback cultures’, Margaret covered a lot of territory and many years of work.
At the core of this program of research was a shift in focus from feedback itself to feedback cultures more broadly.
While we know it is important to consider what educators and learners do to provide, receive, engage in, elicit and act upon feedback messages and conversations, the research moved beyond just considering the educator and/or the learner. Why? Because there is more to it, such as the environment, place and culture in which the research participants work, train, teach and learn. Hence, the research focused on some (enormous) overarching questions about the role of culture, how to adapt to culture, and how to change culture. This approach acknowledged that feedback might mean different things in different cultures.
The research took place in the specialty areas of surgery and intensive care medicine in large busy public hospitals. Both junior doctors (registrars) and senior doctors (consultants) participated.
The junior doctors were trainees in surgical or intensive care training programs to become specialists in their field. The senior doctors held supervisory roles in the training programs. The participants shared different experiences, perspectives and expectations on feedback in their different workplaces, areas of specialty and roles within their unit.
As Margaret and team found out, doctors’ opportunities for and experiences with feedback, as they went about their day-to-day work, were very different across the two specialties. What this showed was that, in this research, the specific culture of each specialty really mattered. Some other key findings included:
Trainees were highly feedback literate
There were limited meaningful conversations about a trainee’s overall progress
There was a culture of silence about emotions
Trainees patched together incomplete progress information for themselves
One of the more recent studies in the program of research was a longitudinal qualitative study conducted with trainees and supervisors: after a workshop about feedback, participants set off to try out some new feedback strategies. Each participant was paired with a member of the research team, who acted as a feedback coach or ‘buddy’, as they trialled the strategies. Every couple of weeks or so, they would report back to their buddy about how they were going. Sometimes, their strategies worked; sometimes, despite their best efforts and intentions, they simply did not. However, the unfulfilled attempts were often due to limited time, the timing not being quite right, rostering mismatches or a higher-priority task suddenly appearing – all unsurprising given the context of extremely busy and highly-pressured workplaces.
From the research, the team developed some practical Feedback Strategies – a set of resources for trainees and supervisors in the two specialties. While they were designed with feedback in medical cultures in mind, you might find them applicable to your area of work too – even if it’s outside of health professions education.
Trainees
What am I left mulling over?
The big questions about culture and feedback culture, and their relevance in higher education. The patching together of information from many sources to work out how you’re going. The reality of uncertainty; some tasks are simply uncertain, so what might feedback look like in those contexts? And, finally, I’m holding on to some of Margaret’s optimism at the very end of the seminar. After sharing a question previously posed by a team member – “Is this as good as it [feedback] gets?” – Margaret replied with a firm “no!”, buoyed by the participants’ dedication: trainees and consultants who genuinely want to improve their workplace feedback cultures.
About Nicole
Nicole Crawford is a Senior Research Fellow currently working on several research projects at CRADLE.
Nicole’s research interests include equity and inclusion in higher education, student and staff mental wellbeing, and enabling education.
Missed the seminar? Catch up on our YouTube channel or our Seminar blog page.
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