1. 1 2009 STReME series Effective Feedback - giving better than what you got - Ann Burke, MD Greg Toussaint, MD Dept of Pediatrics 1 April 2009

2. Post-Game: Giving Feedback A Series of 4 Downs: A Series of 4 Downs: What is feedback? Principles of feedback Delivering the message Heard one? Now do one

3. Giving Feedback What is feedback? Information a system uses to make adjustments… Ende J. JAMA. 12 Aug 1983 Ende J. JAMA. 12 Aug 1983 Intended to improve; sharpen clinical skills Feedback presents information Evaluation summarizes performance; a grade Without feedback, incorrect or ineffective behaviors unwittingly continue

4. Principles of Effective Feedback Well timed and expected Set aside time; inform learner when it will occur Avoid stressful situations for either party Base feedback on first-hand data Use I-messages to convey ownership of info Any important aspect of duties worth including If subjective or second hand, say so

5. Principles of Effective Feedback Focuses on behavior, not individual Offer an informed, objective appraisal Identify clinical skills or actions for improvement Remediable behaviors Positive when deserved; negative to help Should encourage learner to do better Negative not critical of individuals self-worth

6. Delivering the Message Be proactive Observe with intention of giving feedback Know the performance criteria (clerkship objectives) Begin with learners own assessment Use reflective listening to facilitate their conclusion Allows you to assess if any insight present

7. Delivering the Message Offer feedback using principles outlined Provide time for mutual problem-solving See if learner recognizes problem areas Ask for solutions. Be ready with your own Summarize the important issues Get a commitment to follow-up on progress

8. The Two-Minute Drill Remember 6 characteristics of feedback Focus on specifics Non-judgmental Timely Objective Limited Expected Ask – Tell – Ask Ask learners how they think they did/are doing Tell learners what you observed Ask learners how you can help them improve

9. Bucky says… What is feedback? Information to improve clinical skills Part of our responsibility in hierarchy of medical teaching Principles of feedback Positive or negative – always meant as constructive Delivering the message Message needs delivery, even if receiver not interested Does your learner know its feedback? 9

10. Test flight time!