1. Innovation in Student and Resident Feedback in Longitudinal Models
Lisa Grill Dodson, MD Campus Dean, MCW-Central Wisconsin
Stuart Hannah, MD Program Director, Baraboo Family Medicine

2. Disclosures
The speakers have no conflicts of interest to report.

3. Goals
Increase efficiency of evaluation of medical students and residents in the clinical setting
Improve the value of clinical evaluations to learners

4. Feedback vs Evaluation
Formative
Frequent, ongoing
Often free form
Suggestions for further work
Intended to improve performance
Evaluation
Summative
Comparison of actual performance to requirements or standards
Usually standardized
Document achievement or competence

5. Making Feedback Effective
Timely (“on the fly”)
Specific
Actionable
Include both positive and constructive negative
Can be followed up
Specific tools and techniques can help

6. Generational issues: Gestalt vs Micro feedback
Baby Boomers (born ish):
Live to work
General feedback: “No news is good news”
Gen X (born ):
Work to live
Individual feedback
Millenials (born )
Want meaningful work, work-life balance
Expect constant feedback/mentoring, usually positive

7. Resident “Point of Care” Feedback
Direct observation
In the room – role-modeling exams, double checking findings, confirming history, supervising procedures
Video / streaming – HIPAA compliance needed, patient consent, may remove the “observer” effect
Apps
Mobile Medical Milestones – “M3”
Global progress with local details
Field notes – someone to correlate and “see big pic”

8. Old school: Daily goal cards (students)
Goal for day: musculoskeletal exam
Goal for Pt: Shoulder exam
Patient: PJ
Lessons learned (student): shoulder exam is more complicated than I thought
Feedback (faculty): your shoulder exam was not complete, you did not understand several important diagnostic maneuvers
Resources (student or faculty): Read AFP article on shoulder exam
Follow up (student or faculty):
Demonstrate shoulder exam tomorrow
Patient(s):
PJ (shoulder)
LM (back)
GG (ankle)
Feedback (faculty): Review back
exam- you missed several key elements.
Review shoulder surface anatomy. You
provided excellent patient ed on
ankle sprain
Resources (student or faculty): watch Youtube video on shoulder exam
Follow up(student or faculty): demonstrate shoulder exam tomorrow

9. Timeless: TIPPS (students)
“Teach in the Presence of the Patients”
Saves time
Well accepted by patients and students DO
Involve patient as a teacher
Provide praise and gentle correction
DON’T
Reprimand or humiliate student
Engage in complex teaching points or concepts

10. Cutting edge: Daily (on the fly) Voice feedback procedure (students or residents) (instructions for iphone)
Tap “voice memo” app (comes with your iphone)
Click the red button and speak
Give a couple of positives and a couple of points for improvement
Tap red button to end
Click “done”
Name the recording (student name and date)
Click “save”
Tap the recording file
Click on the upload square
Tap on the “message” or “mail” icon, complete the “to” line and click “Send”

11. What are your tips for the group?