The theme of this month's newsletter is "Giving Feedback to Learners." Tips on giving feedback are provided in addition to a succinct review of literature on this topic. The preceptor highlight features thoughts on feedback form Karen Montgomery-Reagan, D.O., a OUCOM faculty member in pediatrics.

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Our preceptor highlight for this month is on Karen Montgomery-Reagan, D.O. Dr. Reagan received her initial osteopathic training from the West Virginia School of Osteopathic Medicine. Dr. Reagan currently serves as Associate Professor of Pediatrics at Ohio University and Chief of Pediatrics at O'Bleness Memorial Hospital in Athens, Ohio. Dr. Reagan has also served as Pediatric Chair at Grandview Hospital & Medical Center, Dayton, Ohio and worked as staff physician at Carson City Hospital in Michigan. Feedback, as Dr. Reagan notes, is an essential part of the teaching/learning experience. When appropriately provided, the trainee obtains perspective and direction regarding their continued growth and development. In addition, Dr. Reagan suggests that feedback should be provided in a private setting and the preceptor must be willing to set aside some “quality time” to review the on-going performance of the trainee. This is especially important when training third year students. Specifically, Dr. Reagan has found that an investment of time is vital when working with third students as they conduct history and physical exams, at least at the beginning and end of their rotations. Reflecting on several years as clinical teacher, Dr. Reagan feels that feedback is greatly enhanced by making sure that the trainee receives an orientation that includes a review of mutual expectations and assignments.

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Research On Feedback

As a major point in their discussion regarding the importance of providing effective feedback, Westberg and Jason (1991) noted that “many learners are so hungry for a sense of how they are doing that they sometimes cling to whatever scraps of clues they can extract from their peers , or scores they get on written tests, even while recognizing how incomplete or even misleading these sources of feedback can be .” Furthermore, based upon their review of literature regarding feedback, Westberg and Jason mention from the Stillman, et al. (1976, 1977) study, “students who received feedback performed significantly better than those who did not.” Similarly, commenting on the findings generated by Hammond (1971), “learners who were given computer feedback on the judgments they were making learned much faster and better than those who received feedback only on the outcomes of their judgments.” As highlighted in the Westberg and Jason review, Skeff's (1983) findings regarding feedback provided to teachers showed “that feedback also accelerates and facilitates the learning of medical teachers.” When setting the stage for feedback, Westberg and Jason mention that “learners are likely to be most open to feedback from those teachers they trust-those whom they feel truly have their best interest at heart.”

Clinical teachers are encouraged to review these and other studies in more detail. Please continue to add your teaching/learning “tool kit”.

References

Hammond, K.R. “Computer graphics as an aid to learning”. Science, 172:903-908, 1971. In Jason, H., Westberg, J. Providing Constructive Feedback. Center for Instructional Support. 1991. p. 5.

Jason, H., Westberg, J. Providing Constructive Feedback. Center for Instructional Support. 1991. pp. 3, 29.

Skeff, K.M. “Evaluation of a method for improving the teaching performance of attending physicians. American Journal of Medicine,75:465-470,1983. In Jason, H., Westberg, J. Providing Constructive Feedback. Center for Instructional Support. 1991. p.5.

Stillman, P.L., Sabers, D.L., Redfield, B.M. “The use of paraprofessionals to teach interviewing skills”. Pediatrics, 57:769-774, 1976. In Jason, H., Westberg,J. Providing Constructive Feedback. Center for Instructional Support. 1991. p.4.

Stillman, P.L., Sabers, D.L., Redfield, B.M. “Use of trained mothers to teach interviewing skills to first year medical students: a follow-up study. Pediatrics, 58:165-169,1977. In Jason, H., Westberg, J. Providing Constructive Feedback. Center for Instructional Support. 1991. p. 4.

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Giving Feedback

Here are 8 suggestions for making the feedback process effective.

1. If feedback is constructive, it should provide an opportunity for the trainee to be open to listening and sharing.
2. The “likelihood” that feedback will be viewed as “helpful” increases when the feedback is: “specific”, includes some “positive” comments as well as an indication of deficiencies, “not demeaning or belittling”, and focused on “behavior” and performance.
3. Strive to practice good communication skills (talking and listening).
4. Ask the trainee to provide a “self-assessment” regarding a particular situation or overall performance.
5. “Look for daily opportunities to provide” feedback.
6. “Schedule periodic conferences” to review the trainee's progress.
7. “Solicit feedback” regarding “your performance” as clinical teacher.
8. Promote feedback as a “learning opportunity.”

Sources:

Getting Along, November 23, 1998. Kathleen Conroy.

Preceptors As Teachers: A Guide to Clinical Teaching. Neal Whitman, Ed.D. and Thomas L. Schwenk, M.D.

Teaching During Attending Rounds. Donn Weinholtz, Ph.D.

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Click here to read an on-line article entitled, Effective Use of Feedback available in the on-line article section of the Society of Teachers of Family Medicine (STFM) web site. Please note that you will probably have to scroll down the page to see the article on role modeling.

Click on the following Web address if you would like to conduct a Medline search using PubMed (http://www.ncbi.nlm.nih.gov/PubMed/) on "."

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Clinical Presentation Curriculum (CPC)

The new Clinical Presentation Curriculum (CPC) began this past fall and replaced the systems curriculum. A distinguishing characteristic of the CPC is the integration of the basic, clinical, and social sciences beginning on day one of study. The traditional basic science courses and systems courses have been discontinued. The CPC is organized around "Blocks" that focus on systems. Students just recently completed the winter quarter Respiratory and Cardiovascular blocks.

A vital component of the new Clinical Presentation Curriculum is the twice weekly case-based learning (CBL) sessions. Each group is comprised of 9 to 10 students and they work together for one quarter and then the groups are reconstituted. A primary purpose of the small group format is to provide the opportunity for collaborative learning. Pictured below are some of the CBL groups enjoying some pleasant weather during the cardiovascular block.

The Spring quarter blocks include Gastrointestinal and Musculoskeletal. Some gastrointestinal cases include Dysphagia, Abdominal Pain, GI Bleeding, Jaundice, Diarrhea-Constipation, and Abdominal Mass. The Spring quarter course coordinator is Leon Wince, Ph.D.

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Each RPAC has developed and delivers a monthly statewide educational day curriculum for their residents.

Educational Days for April are as follows.

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This month (April 6 & 7) the Academic Leadership Fellows will be meeting in Athens. One the evening of April 6, our session will convene at the home of Jim and Olivia Sheehan for dinner and a session on writing skills will be conducted by Michael Weiser. On Friday, April 7, Olivia Sheehan and Elaine Soper will be teaching a session on PowerPoint Skill in the morning and in the afternoon, Todd Slater will be helping each of the fellows develop a personal web page.

If you are interested in participating in the fellowship program, please contact Dennis Baker, Ph.D., Program Director, at bakerd@exchange.oucom.ohiou.edu or call the OUCOM/CORE Office of Faculty Development at 740-593-0157. For additional information on the Academic Leadership Fellowship, click here.

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April is a very busy faculty development month. Events include:

• April 6 & 7, Academic Leadership Fellowship

• April 11, Research Skills workshop for interns/residents at Doctors North

• April 12, Retreat for Columbus family practice residents. Topic will be Leadership Skills: Overview of 7 Habits

• April 13, Workshop for NE CORE interns/residents. Topic will be Clinical Teaching Skills

• April 14, Workshop for NW CORE interns/residents. Topic will be Clinical Teaching Skills

• April 18, Workshop for SW CORE interns/residents. Topic will be Research Skills.

• April 19, Workshop for Peds residents. Topic will be Videoconferencing Skills.

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March, 2000

• March 3, Workshop for KCOM students and family practice residents at PHS Mt. Sinai. Topic was Myers-Briggs Type Indicator
• March 9 & 10, Academic Leadership Fellowship. Primary topic was clinical teaching skills.
• March 17, Workshop for KCOM students and family practice residents at PHS Mt. Sinai. Topic was Case Presentation Strategies.
• March 28, Workshop for Athens OUCOM faculty. Topic was Test Writing Skills.

Ron Russ and Wendy Wozniak participate in a role play to demonstrate feedback skills at Academic Leadership Fellowship session on March10th.

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