Providing Feedback to Learners
"One of the most impactful teaching behaviors in clinical education is to give medical students or residents feedback on their performance." (Whitman, 1990)
Feedback is the sharing of specific information about the student's performance in order to help him/her either continue the behavior or modify the behavior. Providing regular feedback to the student regarding his/her work is the most powerful teaching tool you have. Westberg and Jason (1993) cite the following reasons preceptors should provide constructive feedback during learning.
- Effective feedback can accelerate and facilitate learning.
- Learners value constructive feedback.
- Feedback is often neglected, inadequate, or late.
- Without feedback, learners may make inaccurate assumptions.
- When feedback is insufficient, the importance of formal tests can be inflated.
Therefore, feedback is critical because it provides a basis for maintaining or improving performance. It also provides a forum for assessing need and planning additional experiences. For example, suppose you have observed that your student lacks the necessary skill in performing a certain procedure, the feedback session is then the best venue to recommend corrective action and additional learning opportunities so that the student can improve.
Westberg and Jason also cite the reasons why feedback is avoided and neglected in medical education.
- Many teachers have had no models of constructive feedback to emulate.
- Many teachers and learners have had hurtful experiences with feedback.
- Many teachers and learners fear that feedback might damage their relationship.
- Some clinical teachers think that students know instinctively if they are doing a good job.
Providing Effective Feedback: Tips
The following recommendations for providing feedback are based on the classic article entitled, Feedback in Clinical Education, by Jack Ende (1983).
- Self-Assessment: Before giving feedback, ask the learner to self-assess. The teacher might say, "How do you think you did?"
- Balanced: Provide both positive and critical comments. Begin with the positive comments, then specify where something needs changed, and then end with encouragement. This is called the feedback sandwich.
- Well-Timed: Feedback should be given close to the time of the performance. Immediate feedback is usually best.
- Descriptive & Specific: focus on what the student did, not on personal characteristics. Generalizations such as, "That was a good presentation" are not helpful. The reinforcement is okay but the teacher should also say why the case presentation was good.
- Regularly Provided: Feedback should not be a surprise. it is often provided only when the learner has done something wrong. Establishing a routine of regular feedback prevents this.
References and Resources
Articles & Books
Ende, J. (1983). Feedback in Clinical Medical Education. JAMA, pp.777-781, vol. 250:6.
Westberg, J. and Jason, H. (1993). Collaborative Clinical Education.
Whitman, N. (1990). Creative Medical Teaching.
On-Line Resources
Effective Use of Feedback by Kaprielian, V.S. and Gradison, M. (Nice 3 page article)
Providing Feedback to Learners by Baker, D. ( A PowerPoint Presentation given to South Pointe preceptors)
Providing Feedback (Important tips on feedback from the "New Preceptor Packet" located on the OUCOM/CORE Office of Faculty Development Web Page)