1. Effective Techniques and Strategies
Feedback for Learners
Effective Techniques and Strategies
Jennie Hsu-Lumetta, M.D.
April 4, 2005
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2. Goals and Objectives 1. Define the purpose of giving feedback
2. Identify the characteristics of providing effective feedback.
3. List 3 levels of feedback.
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3. What Will Be Covered. . . 1. Definition, Purpose, Types of Feedback
2. Characteristics of Effective Feedback
3. Levels of Feedback
4. Cases
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4. Definition of Feedback
The process by which the teacher provides learners with information about their performance for the purpose of improving their performance.
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5. Evaluation of Learners
The process by which the teacher assesses the learners’
knowledge, skills, and attitudes, based on criteria related to educational goals.
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6. 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
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7. When to give Feedback? Assessment/Evaluation Feedback Evaluation
Formative (ongoing)
Feedback
Evaluation
Summative (end of rotation)
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8. Characteristics of Effective Feedback
Specificity
Frequency
Timing
Positive/Negative
Learner Reaction
Action Plan
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9. Characteristics of Effective Feedback
1. Specificity
Precise
Specific examples or behaviors
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10. Characteristics of Effective Feedback
2. Frequency
Give as frequently as possible (not only at end of the rotation!)
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11. Characteristics of Effective Feedback
3. Timing
Deliver as close in time to the incident either individually or in group if applicable
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12. 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
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13. Characteristics of Effective Feedback
4. Positive/Negative
Giving both Positive (reinforcing) and Negative (corrective) can be useful for learners.
“Feedback sandwich”
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14. Characteristics of Effective Feedback
5. Learner Reaction
The learner can benefit from an opportunity to react to the feedback.
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15. Characteristics of Effective Feedback
6. Action Plan
Develop an action plan for improvement, preferably with learner input.
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16. Levels of Feedback Minimal Feedback Behavioral Feedback
Interactive Feedback
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17. 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.”
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18. 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.”
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19. 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?”
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20. 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.
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21. 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.
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22. 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!”
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