Theoretical construction and tool development of the “West China Four-Step Feedback Method” for medical simulation and clinical practice teaching_West China Medical Journal

Authors：

WANG Xingrui ¹ , QUAN Zhiyue ¹ , CHAI Hua ^1,2 ,  YAN Yujiang ^1,2

1. Zhulang Center for Professional Advancement, West China Second University Hospital (Key Laboratory of Birth Defects and Related Diseases of Women and Children), Sichuan University, Chengdu, Sichuan 610066, P. R. China;
2. National Research Center for Educational Materials, Chengdu, Sichuan 610000, P. R. China;

Corresponding?author：

YAN Yujiang, Email: 709478999@qq.com

Keywords：

Medical simulation teaching; clinical practice teaching; Four-Step Feedback Method; pocket-size card

DOI：

10.7507/1002-0179.202511350

Video：

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Feedback plays a vital role in medical simulation and clinical practice teaching. Nevertheless, there is a lack of an effective structured theoretical model to improve the teaching feedback quality. Guided by the “learning-centered” educational philosophy and relevant medical education theories, the teaching team from West China Second University Hospital, Sichuan University explored and established the “West China Four-Step Feedback Method” for medical simulation and clinical practice teaching, and developed supporting auxiliary teaching tools. This article introduces the construction and operational mechanism of the aforementioned feedback model, the design and optimization process of the auxiliary teaching tools. Its theoretical value, practical application value, limitations and future research directions are also discussed.

Citation： WANG Xingrui, QUAN Zhiyue, CHAI Hua, YAN Yujiang. Theoretical construction and tool development of the “West China Four-Step Feedback Method” for medical simulation and clinical practice teaching. West China Medical Journal, 2026, 41(8): 1333-1337. doi: 10.7507/1002-0179.202511350 Copy

1.	徐文婷, 林克蘭, 何家欣, 等. 情景模擬教學中引導性反饋實踐方法的證據總結[J]. 中國護理管理, 2025, 25(4): 546-552.
2.	郭偉, 徐維隆. 自我決定動機理論視角下教學改革促進本科生學習動機路徑評估[J]. 高教學刊, 2023, 9(14): 146-149, 154.
3.	Sandars J. The use of reflection in medical education: AMEE guide No.44[J]. Med Teach, 2009, 31(8): 685-695.
4.	Singaram VS, Pillay R, Mbobnda Kapche EL. Exploring the role of digital technology for feedback exchange in clinical training: a scoping review[J]. Syst Rev, 2024, 13(1): 298.
5.	羅瑤, 李燕. 視頻反饋聯合模塊教學在新生兒學教學中的應用[J]. 中國繼續醫學教育, 2025, 17(7): 118-122.
6.	修文龍, 楊斌, 任艷麗, 等. 視頻反饋教學法在新生兒復蘇案例模擬教學中的應用——以本科醫學生為例[J]. 福建醫科大學學報(社會科學版), 2021, 22(3): 78-81.
7.	Dohms MC, Collares CF, Tibério IC. Video-based feedback using real consultations for a formative assessment in communication skills[J]. BMC Med Educ, 2020, 20(1): 57.
8.	李春芝, 夏利敏, 賀才榕, 等. 建設性反饋教學在護理臨床教學中的應用效果評價[J]. 護理實踐與研究, 2021, 18(14): 2174-2177.
9.	宋燕. 雙向反饋教學法在本科護生臨床實踐教學中的應用[J]. 臨床合理用藥雜志, 2009, 2(14): 112-113.
10.	宋亮, 闕國鷹, 姚玨琦, 等. 引導式教學法在口腔實踐教學中的應用[J]. 口腔醫學研究, 2008, 24(1): 97-98.
11.	Burt L, Fitz S, Kiser B. Evidence-based simulation: fostering competency through structured and multisource feedback[J]. J Am Assoc Nurse Pract, 2024, 36(12): 696-703.
12.	Hattie J, Timperley H. The power of feedback[J]. Rev Educ Res, 2007, 77(1): 81-112.
13.	Ramani S, Krackov SK. Twelve tips for giving feedback effectively in the clinical environment[J]. Med Teach, 2012, 34(10): 787-791.
14.	趙炬明. 論新三中心: 概念與歷史——美國 SC 本科教學改革研究之一[J]. 高等工程教育研究, 2016(3): 35-56.
15.	Borkowski JG, Carr M, Pressley M. “Spontaneous” strategy use: perspectives from metacognitive theory[J]. Intelligence, 1987, 11(1): 61-75.
16.	Anderson LW, Krathwohl DR, Airasian PW, et al. A taxonomy for learning, teaching, and assessing: a revision of Bloom’s taxonomy of educational objectives[M]. New York: Longman, 2001.
17.	Masters K. Edgar Dale’s pyramid of learning in medical education: further expansion of the myth[J]. Med Educ, 2020, 54(1): 22-32.
18.	Deci EL, Ryan RM. Self-determination theory: a macrotheory of human motivation, development, and health[J]. Can Psychol, 2008, 49(3): 182-185.
19.	Telio S, Ajjawi R, Regehr G. The “educational alliance” as a framework for reconceptualizing feedback in medical education[J]. Acad Med, 2015, 90(5): 609-614.
20.	Bing-You R, Hayes V, Varaklis K, et al. Feedback for learners in medical education: what is known? A scoping review[J]. Acad Med, 2017, 92(9): 1346-1354.
21.	Abela J. Adult learning theories and medical education: a review[J]. Malta Med J, 2009, 21(1): 11-18.

1. 徐文婷, 林克蘭, 何家欣, 等. 情景模擬教學中引導性反饋實踐方法的證據總結[J]. 中國護理管理, 2025, 25(4): 546-552.
2. 郭偉, 徐維隆. 自我決定動機理論視角下教學改革促進本科生學習動機路徑評估[J]. 高教學刊, 2023, 9(14): 146-149, 154.
3. Sandars J. The use of reflection in medical education: AMEE guide No.44[J]. Med Teach, 2009, 31(8): 685-695.
4. Singaram VS, Pillay R, Mbobnda Kapche EL. Exploring the role of digital technology for feedback exchange in clinical training: a scoping review[J]. Syst Rev, 2024, 13(1): 298.
5. 羅瑤, 李燕. 視頻反饋聯合模塊教學在新生兒學教學中的應用[J]. 中國繼續醫學教育, 2025, 17(7): 118-122.
6. 修文龍, 楊斌, 任艷麗, 等. 視頻反饋教學法在新生兒復蘇案例模擬教學中的應用——以本科醫學生為例[J]. 福建醫科大學學報(社會科學版), 2021, 22(3): 78-81.
7. Dohms MC, Collares CF, Tibério IC. Video-based feedback using real consultations for a formative assessment in communication skills[J]. BMC Med Educ, 2020, 20(1): 57.
8. 李春芝, 夏利敏, 賀才榕, 等. 建設性反饋教學在護理臨床教學中的應用效果評價[J]. 護理實踐與研究, 2021, 18(14): 2174-2177.
9. 宋燕. 雙向反饋教學法在本科護生臨床實踐教學中的應用[J]. 臨床合理用藥雜志, 2009, 2(14): 112-113.
10. 宋亮, 闕國鷹, 姚玨琦, 等. 引導式教學法在口腔實踐教學中的應用[J]. 口腔醫學研究, 2008, 24(1): 97-98.
11. Burt L, Fitz S, Kiser B. Evidence-based simulation: fostering competency through structured and multisource feedback[J]. J Am Assoc Nurse Pract, 2024, 36(12): 696-703.
12. Hattie J, Timperley H. The power of feedback[J]. Rev Educ Res, 2007, 77(1): 81-112.
13. Ramani S, Krackov SK. Twelve tips for giving feedback effectively in the clinical environment[J]. Med Teach, 2012, 34(10): 787-791.
14. 趙炬明. 論新三中心: 概念與歷史——美國 SC 本科教學改革研究之一[J]. 高等工程教育研究, 2016(3): 35-56.
15. Borkowski JG, Carr M, Pressley M. “Spontaneous” strategy use: perspectives from metacognitive theory[J]. Intelligence, 1987, 11(1): 61-75.
16. Anderson LW, Krathwohl DR, Airasian PW, et al. A taxonomy for learning, teaching, and assessing: a revision of Bloom’s taxonomy of educational objectives[M]. New York: Longman, 2001.
17. Masters K. Edgar Dale’s pyramid of learning in medical education: further expansion of the myth[J]. Med Educ, 2020, 54(1): 22-32.
18. Deci EL, Ryan RM. Self-determination theory: a macrotheory of human motivation, development, and health[J]. Can Psychol, 2008, 49(3): 182-185.
19. Telio S, Ajjawi R, Regehr G. The “educational alliance” as a framework for reconceptualizing feedback in medical education[J]. Acad Med, 2015, 90(5): 609-614.
20. Bing-You R, Hayes V, Varaklis K, et al. Feedback for learners in medical education: what is known? A scoping review[J]. Acad Med, 2017, 92(9): 1346-1354.
21. Abela J. Adult learning theories and medical education: a review[J]. Malta Med J, 2009, 21(1): 11-18.

West China Medical Journal

Theoretical construction and tool development of the “West China Four-Step Feedback Method” for medical simulation and clinical practice teaching

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