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Providing Successful Feedback (Parts 1 & 2)
Presented by: Ed Zalneraitis, M.D., Director, The Office of Medical Education at CCMC and The Pediatric Residency Program
Paula Algranati, M.D., Director of Medical Education, Department of Pediatrics
Goals:
- To understand the potential barriers in giving feedback
- To understand what is gained by giving feedback
- To learn practical techniques in giving feedback
- To provide opportunities for workshop participants to practice giving feedback
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The steps toward providing successful feedback:
The identification of what learners find helpful from constructive feedback as well as what is unhelpful were reviewed. Among common remarks obtained from our pediatric rotators included the following positive assertions;
- being concise and constructive,
- pointing out weaknesses and strengths,
- reassurance about abilities and directions as to how to improve,
- practical, honest, and continuous communication
Those key elements not found to be particularly helpful and to be avoided included;
- being vague, especially simply saying "you're doing well" without identifying areas to work on,
- not setting aside a specific time to sit and provide feedback
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Shifting Paradigms
We who provide feedback must be wary of unintended reinforcement as a substitute for meaningful feedback. In order to become more proficient at providing better feedback we need to be cognizant of its value and develop a practical approach to providing it.
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Defining Feedback
Learners need to know what they are doing right and wrong. They desire and value effective feedback. This will strengthen the Teacher-Learner relationship and demonstrates the interest of the teacher toward the learner.
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Outline ahead of time: The "Feedback Sandwich"
- What the learner did well
- What the learner did not do well
- What the learner could do to improve
- Reinforce positive behaviors since silence indicates approval and mistakes will go uncorrected
- This will provide valuable information of performance and set expectations for improvement
- This will convey an attitude of concern for the overall development of competence of the learner
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Characteristics of Constructive feedback
Feedback should be based upon first-hand knowledge. This implies direct observation. It should be descriptive and specific not evaluative and general. Preparation and delivery can be provided using the following six steps:
- Preparation of the teacher (collect data, prepare an outline, determine how much to discuss)
- Preparation of the learner (choose time/place ahead of time, relaxed setting, explain the agenda)
- Learner self-assessment (ask how the learner felt about their performance, open-ended questions)
- Provision of positive and corrective feedback ("feedback sandwich, be specific and non-judgmental)
- Provide an improvement plan (invite learners suggestions, give your suggestions, assess acceptance of feedback)
- Check learner understanding and Obtain learner acceptance (have learner state what needs change, the plan for change, and the consequences of not changing)
Summarized by F. DiMario
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