Effective Techniques and Strategies Feedback for Learners Effective Techniques and Strategies Jennie Hsu-Lumetta, M.D. April 4, 2005 4/5/2019

Goals and Objectives 1. Define the purpose of giving feedback 2. Identify the characteristics of providing effective feedback. 3. List 3 levels of feedback. 4/5/2019

What Will Be Covered. . . 1. Definition, Purpose, Types of Feedback 2. Characteristics of Effective Feedback 3. Levels of Feedback 4. Cases 4/5/2019

Definition of Feedback The process by which the teacher provides learners with information about their performance for the purpose of improving their performance. 4/5/2019

Evaluation of Learners The process by which the teacher assesses the learners’ knowledge, skills, and attitudes, based on criteria related to educational goals. 4/5/2019

ASK’s Attitude, Skills, Knowledge Competency includes the following: Attitude: (as observed via behaviors) Prepared/Punctuality/Proactive Follow-up with patient/educational issues Skills – context specific Knowledge Has the information Able to analyze and synthesize information Able to apply it effectively and efficiently 4/5/2019

When to give Feedback? Assessment/Evaluation Feedback Evaluation Formative (ongoing) Feedback Evaluation Summative (end of rotation) 4/5/2019

Characteristics of Effective Feedback Specificity Frequency Timing Positive/Negative Learner Reaction Action Plan 4/5/2019

Characteristics of Effective Feedback 1. Specificity Precise Specific examples or behaviors 4/5/2019

Characteristics of Effective Feedback 2. Frequency Give as frequently as possible (not only at end of the rotation!) 4/5/2019

Characteristics of Effective Feedback 3. Timing Deliver as close in time to the incident either individually or in group if applicable 4/5/2019

Opportunities for Feedback : Read and respond to learner’s patient notes Include the learner in procedures Look at MRI’s, xrays, slides etc. Case presentations and physical exam by learners Personal encounters with patients, staff and other health care encounters 4/5/2019

Characteristics of Effective Feedback 4. Positive/Negative Giving both Positive (reinforcing) and Negative (corrective) can be useful for learners. “Feedback sandwich” 4/5/2019

Characteristics of Effective Feedback 5. Learner Reaction The learner can benefit from an opportunity to react to the feedback. 4/5/2019

Characteristics of Effective Feedback 6. Action Plan Develop an action plan for improvement, preferably with learner input. 4/5/2019

Levels of Feedback Minimal Feedback Behavioral Feedback Interactive Feedback 4/5/2019

Levels of Feedback 1. Minimal Feedback Tell learners that performance is correct or incorrect Agree or disagree with learners opinions Use nonverbal cues like nodding Examples: “That’s correct.” “You make a mistake.” 4/5/2019

Levels of Feedback 2. Behavioral Feedback Describe learner performance as behaviors Tell learner why performance is correct or incorrect Give reasons for agreement or disagreement with leaner Offer behavioral suggestions for improvement Examples: “Your case presentation was clear and well-organized.” 4/5/2019

Levels of Feedback 3. Interactive Feedback Acknowledge learner’s situation/admit limitations Agree on goals with learner Involve learner in self-assessment Give learner feedback on performance and self-assessment Elicit learner reaction to feedback Develop an action plan with feedback Prompts: “What do you want to change?” 4/5/2019

Summary for Effective Feedback: Find opportunities for giving feedback that is timely and ongoing Give frequent and specific feedback Provide reinforcing and corrective feedback Involve learner in self-assessment and reaction to feedback Develop an action plan on improving future performance in regards to knowledge, skills and attitudes. 4/5/2019

Case 1 Your 3rd year medical student has had 2 previous interaction problems with inpatients that have required nursing involvement to resolve. Today on call, the student admitted a patient post-op s/p modified radical mastectomy for rule-out DVT. The patient requests to talk to you alone after the student has seen the patient. The patient then states that the student is completely insensitive, showing no compassion whatsoever, was “rough” during the PE and generally showed poor professional demeanor. 4/5/2019

Case 2 You are completing your 3rd month as an R2, feeling frustrated at the lack of feedback or formal evaluation, and are not really sure how you are doing, Fortunately, there have been no glaring errors and your teams have functioned quite well with hard-working interns. Previous attending comments : “Good job. I really enjoyed working with you!” 4/5/2019