Teaching Resources

Tips for Feedback (printable sheet)

Specific, individualized, constructive feedback is one the most valued and at the same time neglected aspects of medical education. Few physicians are taught how to provide feedback yet we are expected to perform this critical function nearly every day. The concepts and skills needed to provide good feedback are not difficult, but they require practice. The information below should serve as a guide.

10 Keys to success

♦ Recognize that feedback is different than evaluation.
♦ Provide specific examples with descriptive, non-judgmental language
♦ Focus on remedial behaviors and feasible solutions
♦ Label subjective data as such
♦ The focus is on what is said and done rather than “why”
♦ Involve the recipient in the process (exploration, problem solving, planning)
♦ Solicit recipient’s perspective and feelings
♦ Be aware of your assumptions, opinions and feelings
♦ Check the degree of agreement and clear communication.
♦ Follow-up with attention to the consequences of feedback.

Important to remember – “feedback” is different from “evaluation and grades” and different from “advice”. Evaluation is typically general and focused on the person (rather than behavior). Feedback is specific, focused on behaviors and timed to best share information. One of the biggest mistakes is feedback attempts which blur this distinction.
Feedback should:
  • congratulate successes and reinforce desired behaviors
  • ensure the trainee understands your expectations and priorities while letting them know what corrective actions are needed and how to make them.
To give effective feedback:
  • Ensure the individual is ready and able to receive feedback.
  • Ask for permission to give feedback. As an example, “may I give you feedback on your patient work up?” is a good start.
  • Provide feedback regularly. Giving feedback in a timely fashion is critical.
  • Ensure a private location where the trainee feels safe. Remember the adage, “public praise and private criticism”.
  • Feedback should be objective & involve specific behaviors. Use “I noticed…” and “I observed…”.
  • Be very clear in what was good and what was bad with the behavior observed.
  • “Great job” is a grade, not feedback.
  • Offer clear and specific suggestions for improvement/change. There is no room for ambiguity.
  • Avoid judgmental statements and describe rather than evaluate specific behavior. For example, “Steve, I noticed that you have not been at the last 5 clinical conferences. These are a great opportunity to develop your clinical skills. Is there something preventing you from attending?” rather than “You seem to not care about improving your clinical skills”.
  • Give the learner a chance to respond. Asking how they felt they did is an opportunity for self-reflection and is a powerful learning tool.
  • Define how the behavior affects others. For example, “Julie, when you delay completion of your dictations, the referring doctor may have a hard time executing our treatment plan”, rather than “your record keeping is poor”.
  • If the trainee is resisting your message, or starts defending him/herself, try to present your observations as an opinion to consider. “This is my view of you. I want to make sure you have a good view of how I see you. Perhaps you should check with some other sources.” Remember, your goal is to improve their understanding, not to provide them with “the truth.”
Step-Wise Approach to Feedback
  • Prepare before meeting:
    • Establish rapport
    • Create supportive feedback environment
    • Observe, collect data
    • Establish agreed upon goals and timing of the meeting
  • Elicit recipient self assessment
  • Reinforce desired behaviors
  • Identify, analyze challenges & undesired behaviors
  • Problems solve, generate alternatives
  • Assess recipient understanding and acceptance
  • Close effectively
    • Summarize
    • Plan for follow-up
7 questions to ask yourself about whether you gave good feedback
  1. Was it clear and unambiguous?
  2. Was it specific?
  3. Was it directed at a behavior and not a person?
  4. Was it supportive, formative and developmental?
  5. Was it timely?
  6. Was it understood?
  7. Was it delivered in an appropriate environment?