Feedback

Feedback Learning depends on self-regulation Self regulation depends on learners being able to access information that tells them the gap between where they are and where they need to be Feedback is therefore ‘the lifeblood of learning’…. Good place to start is with Knowles. He addresses a number of items on that list Go through these and explain a little more fully. Ask group – does this seem valid to them? Reference them back to your heavy focus on why they need to know about learning theory at the induction day and the start of today. In doing this I was attempting to enhance the need to know, the readiness, the orientation and the motivation. @NHS_HealthEdEng

feedback

What is…. …your experience of receiving feedback? …your experience of giving feedback? @NHS_HealthEdEng

Literature shows feedback often useless and sometimes counter-productive @NHS_HealthEdEng

Feedback is only one source of cue about learning and performance Acceptance and uptake of feedback is complex and not assured Depends on; Learner perceptions of evaluator credibility as role model Learner receptivity to constructive criticism Alignment with learner’s learning goals and self-assessment @NHS_HealthEdEng

Can we establish some general principles for giving feedback? @NHS_HealthEdEng

Principles of feedback in the clinical setting Make it normal a everyday thing Ensure that learners are clear about the criteria against which their performance will be judged. Feedback at the time of an event or shortly afterwards. Feedback should be limited to one or two items only Make sure it is a two-way conversation Check the learner understands the feedback @NHS_HealthEdEng

The Conscious Competence Model The learner is unaware of their lack of a particular skill Unconscious Incompetence The learner grasps the importance of a skill but fails when trying to attempt it Conscious Incompetence The learner is able to do the skill but has to think about each step Conscious Competence The learner is now able to do the skill without much thought Unconscious Competence

Johari’s Window Perceived Needs -in the two left boxes. The Façade is explored by disclosure from the trainee. Aided by the trainer creating the right environment The trainer role modelling the process Known to self Unknown to self Unperceived Needs -in the two right boxes. The Blind Spots box - trainer traditionally opens by giving constructive feedback - now mainly comes from the WPBA tools. The Hidden box opened up by joint exploration between trainer and trainee helped by the trainer’s ability to ask telling questions and a curiosity and interest in the trainee’s development. Known to others OPEN ARENA - by definition doesn’t need exploring BLIND SPOTS - explored by feedback Unknown to others FAÇADE - explored by disclosure HIDDEN - revealed by joint exploration

Miller’s Pyramid Linking knowledge to skills NOVICE Knowledge Skills Attitudes EXPERT Does Shows how Knows How Knows Helps answer the questions- what level of clinical competence are we aiming for? And what is the best assessment method? KNOWS: MCQs e.g. has some knowledge about ethics KNOWS HOW: EMQs/ essays e.g. could present an ethical case SHOWS: e.g. OSCE examination/ CBD DOES: e.g. routine observation/ videos

What feedback models do you know? @NHS_HealthEdEng

Pendleton’s Rules… …problems? @NHS_HealthEdEng

ALOBA Agenda – led Outcomes Based Analysis; Agenda - ask the learner to highlight problem areas Define Outcomes- what do we want to achieve Elicit the learner’s thoughts and feelings and get him/her to make suggestions about how things could be better Involve the group in problem solving Facilitator then makes suggestions and generalises the learning Check everyone happy that the agenda is covered and feedback appropriate @NHS_HealthEdEng

SET-GO What do you See What Else do you see What do you Think (encourage the learner to reflect and problem-solve) then to group: What Goal would we like to achieve Any Offers of how to get there (rehearse suggestions as appropriate @NHS_HealthEdEng

Unconscious incompetence Conscious competence Unconscious competence learner Low level of competence. Unaware of failings Low level of competence. Aware of failings but not having full skills to correct them Demonstrates competence but has to think about activities Carries out tasks with conscious thought. Skills internalised and routine. Little or no conscious awareness of detailed processes involved in activities teacher Helps learner to recognise weaknesses, Helps learner to develop and refine skills, reinforces good practice and competence, demonstrates skills Helps learner develop/refine skills, reinforces good practice through positive regular feedback Raises awareness of detail and unpacks processes for more advanced learning, notes any areas of weakness/bad habit