1. Insert grabber Video

2. Giving Effective Feedback Making A Better Sandwich
Sameer Khatri, MD
Faculty Development Fellowship
Hi, I am…….We are going to talk to you about effective feedback: “making a better sandwich.” Talk briefly about the old P-N-P sandwich.

3. Objectives Reviewed importance of feedback
Defined feedback vs. evaluation
Identified barriers to feedback
Identified ingredients of effective feedback
Applied effective feedback techniques
By the end of this presentation, we will have reviewed the importance of feedback, define….. And identified ingredients or (principles) of effective feedback.

4. Activity #1 Feedback reflection
Write down 1-2 words that come to mind when you think of feedback
Be prepared to discuss with group
So what were the recurring words or themes in your group? Good…these are all good points and we will build on these and go more in detail in this presentation.
2 minutes

5. Activity #2 Read and highlight what you think are:
Reasons feedback is important
Principles of effective feedback
Ways to give better feedback
Be prepared to discuss with group
These notable and often quoted articles about effective feedback. We would like you to read and highlight what YOU think are….
Be prepared to discuss possible new ideas or concepts you learned from your article.
So…share what you learned…
8 minutes

6. Feedback: Why bother?
“The goal of clinical training is expertise in the care of patients. Without feedback, mistakes go uncorrected, good performance is not reinforced and clinical competence is achieved empirically or not at all."
So Why bother? From the article and the group comments, we know that feedback is important.
-Ende J: Feedback in clinical medical
education. JAMA 250(6):777-81, 1983

7. Johari Window Known to Self Unknown to Self Self Awareness
Feedback
Self Awareness
Mutual Understanding
Open/Free
Area
(Personal Growth)
Blind
Area
Known to
others
The importance of effective feedback is further demonstrated by the Johari window model. The Johari Window model is a simple and useful tool for illustrating and improving self-awareness, and mutual understanding between individuals within a group. NOTE! The model empathizes the importance of DIALOGUE in giving feedback.
The aim in any group should always be to develop the 'open area' for every person, because when we work in this area with others we are at our most effective and productive, and the group is at its most productive too. The open free area, or 'the arena', can be seen as the space where good communications and cooperation occur, free from distractions, mistrust, confusion, conflict and misunderstanding.
Unknown
to others
Hidden
Area
Unknown
Area

8. Feedback: What is it?
So we now know why feedback is important, but what is it? Are learners and instructors on the same page about what feedback is? Watch and try to remember feedback issues in this video?
I agree. There appears to be confusion on what feedback is and the difference between feedback and an evaluation. As we discussed earlier, feedback is the information we get back to help us grow and learn.

9. Activity #3 Feedback vs. Evaluation
Place descriptive words under Feedback or Evaluation
Be prepared to discuss with group
3 minutes

10. Feedback vs. Evaluation
Immediate
Scheduled
Informal
Formal
Observation
Objective
Event specific
Global performance
Improvement
Grading
Dialogue
Monologue
Feedback vs. Evaluation
This is what we got. As you can see there are seminaries and differences. The key to keep in mind is that feedback is a Dialogue. It is important in order to expand the open arena in the Jahari window

11. What are your barriers to feedback?
Kris: So what are the barriers to giving feedback? These are your responses. As you can see, these are similar to what you just read in the readings. How would you suggest overcoming these barriers (maybe put this question into the slide)?

12. Effective Feedback What are the ingredients?
As we are getting ready to give feedback or give a feedback “sandwich,” we can ask ourselves, what are the principles or “ingredients” of effective feedback?

13. Principles of Effective FeedbackM E T L C
Specific
Objective
Modifiable Behaviors
Expected
Timely
Limited
Constructive
At this point we have identified most of these key principles or ingredients. We have made these principles into an acronym that may make it easier for you to remember. We like to encourage you to give SOME TLC when giving feedback
--Specific- concise, instead of good job, be specific. Your hands shake instead of clumsy..
--Objective-based upon observations and witnessed performance only and not hearsay
--Modifiable-focus on behaviors that are modifiable or/and will likely be repeated. You are addressing the behavior, not the individual
--Expected-schedule. don’t blind side. Make it expected before an event
--Timely-after every encounter or event. Timely also means appropriateness. There is an emotional issues that requires things to cool off a bit. Good timing for feedback also ensures safety for the learner.
--Limited. People tend to be able to deal with things in smaller amounts including feedback. Plus it is less time consuming. Give less but more frequent
--Constructive-keep in mind that feedback is designed to help the learner improve and should be given for no other reason. Safety is also part of this key principle

14. Activity #4 In groups of 2, each person pick one scenario
Practice SOME-TLC
In groups of 2, each person pick one scenario
Read and highlight key points you would use when giving feedback
Read the following learner observations. Highlight SOME TLC principles in preparation for giving your learner feedback. Save for activity #5
3 minutes

15. Old Feedback Sandwich Not very palatable Positive Negative
So we have our ingredients. How do you we put it together. As discussed earlier the old P-N-P sandwich can be rather dry. Is there a better way?
Not very palatable

16. New Feedback Sandwich Ask Tell / Teach Act
So what we propose is the new Sandwich using Ask…

17. Ask Ask learner to assess their own performance
How do you think you did?
What do you think went well?
Did you have any problems?
Good way to start conversation
Automatically engages the learner
Reveals learner’s insight

18. Tell / Teach Tell I observed... It seemed as though…
When you do __I feel__...
Teach (short pearls)
In my experience….
Consider…
Used to address learners assessments
Address positive and negative behaviors
Address learners comments after initial “ASK”
Non judgmental
Focused teaching (short pearl)

19. Ask Ask learner to reflect and analyze What do you think of…
my observations?
my comments?
What would you do differently?
What can we do to improve?
Gets learner’s buy in
Ensures learner’s understanding
Demonstrates mutual respect

20. Act Summarize key points Demonstrate Re-assess Commit to a plan
Feedback without teacher’s willingness to follow up or support is of little value. End on positive note

21. ASK ASK ACT TELL/TEACH Why Ask-Tell-Ask-Act?
With each step there is increase in knowledge flow. Finally the knowledge is then able to be channeled to an action and change
TELL/TEACH

22. Activity #5 Build a new feedback sandwich Use SOME TLC in activity #4
Take turns giving feedback using Ask-Tell / Teach-Ask-Act
Now we have our ingredients and a way to build our new feedback sandwich. This exercise…
10 minutes

23. How did it go? OR

24. How did it go?

25. Activity #6 Call to Action
List what you will do in the next month to improve feedback to our students
Be prepared to share

26. Objectives Reviewed importance of feedback
Defined feedback vs. evaluation
Identified barriers to feedback
Identified ingredients of effective feedback
Applied effective feedback techniques
By the end of this presentation, we will have reviewed the importance of feedback, define….. And identified ingredients or (principles) of effective feedback.

27. Take Home Points Feedback is essential Feedback is desired by learners
Effective feedback requires preparation
Give SOME-TLC via Ask-Tell-Ask-Act
Tien: By the end of this presentation, we will have reviewed the importance of feedback, define….. And identified ingredients or (principles) of effective feedback.

28. Questions?