Module 5:

Giving and Receiving Feedback

Approximate time to
complete module:
10 minutes
 Objectives
Explain the importance of providing timely feedback

Incorporate strategies for providing constructive feedback

Identify benefits of effective feedback to students and

preceptors

Identify ways to incorporate feedback into clinical teaching

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 Definition
Feedback is the process of conveying
the preceptor’s observation to the
student about his/her performance,
with the intent to promote growth,
improvement in performance and
progression towards a desired
objective.

The process is immediate, occurs

informally and is guided by a purpose
or intended outcome.

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 Outcomes of Feedback
Giving feedback is important because it can:

Improve performance and confidence

Clarify the preceptor’s expectation
Increase morale
Develop teamwork

A lack of good feedback can:

Demoralize
Reduce confidence
Cause conflict

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 Ineffective Feedback
Feedback may not be effective because of:

Ineffective communication
Poor timing as in it was not given in the
moment
Giving too much information
Not having a balance of positives with
needs for improvement
Too little support and not enough
challenge

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 Effective Feedback
Be clear and specific about what feedback you want to give:

This will avoid being misunderstood; decrease the opportunity for anxiety to
arise and diminish the potential for the student to be argumentative
Discuss how the behaviour or action was accomplished rather than giving
general comments which are hard to learn from
Avoid using definitive words such as “all the time,” “never,” and “always” and try
to be more specific

Be respectful:

Ensure privacy and adequate time to complete the discussion

Be consistent with your verbal and non-verbal cues

Avoid
Slide 6 of 19being accusatory:
 Involve the Student
Discuss the feedback process with the student at the beginning of the placement
experience. Discuss:

When feedback will be provided: immediately after an activity has been

completed, “on the fly,” or at the end of the day
Will feedback be provided for all activities: direct patient care activities,
case presentations, etc.
Will other staff be involved in providing feedback
What the student’s role will be in the process
How the feedback will be used in the evaluation process

Encourage your student to start first by posing a question about their behaviour
and asking them to verbalize their thoughts on what the did well and what needs
improving.

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 Involve the Student
Validate things your student has identified that are accurate and
expand with your perspective

Give your student time to think and respond

Ask your student to come up with strategies for improving his/her

performance by focusing on alternatives rather than on one solution

Provide guidance in what the student could consider to improve if

s/he is unsure how to proceed or overcome challenges

Obtain feedback from your student on your feedback with questions

such as: What do you think?” Do you agree? How do you feel
about…?
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 Be Timely
The most effective feedback is based on direct observation by the preceptor and
provides immediate feedback.

Allot some time in the day to observe one activity and keep the observation short
and focused

Explain to patients and patients that you are there to observe

Allow the student to complete the task if patient safety is not compromised

Determine if your student reacts well to immediate feedback or if s/he needs time to
self-reflect first and then receive feedback.

Give feedback as close to the event as possible so the person can reflect on the event
and do something about it. Delaying feedback can result in storing up grievances, then
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delivering them in one difficult to handle package.
 Be Focused
Concentrate on what can be changed by
providing feedback on a specific action or
statement

Relate the feedback to the objective of the

placement

Limit the information you provide to the

amount the person receiving it can use – bite-
size rather than the full amount you have and
might like to give

Practice being a one minute supervisor

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 Balanced Feedback
Balanced feedback has the greatest impact on changing behaviour and
improving performance:

Feedback should be balanced between the extremes of absolute

honesty “telling it like it is” and the “avoiding telling it” – usually done
to maintain relationships.

Provide positive feedback as well as constructive criticism. You can

always find something good to say, even if it is a small item.

Try to find occasions where you can give only positive feedback. This
offsets the rough times when there is more constructive criticism than
positive feedback.
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 Frequency of Feedback
“Supposing is good, but finding out is better.”

Learners need feedback on their learning, early and often.

If the student is a beginner at performing a task, direct and frequent

feedback following teach session may be necessary.

If the student is not a beginner, then feedback every few days may
be adequate, although self-reflection should be encouraged
following each session.

“Without feedback, mistakes go uncorrected, good performance is

not
Slide 12 ofreinforced,
19 and clinical competence is achieved empirically or
 What Students want to Know

What was done right?

What needs improving?

What do I do next time?

All learners can improve on something.

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 Own Your Feedback
The feedback you give is your perception and not the
ultimate truth. To reflect this, use phrases such as:
“I noticed” – instead of “You did”
“I find your actions” – instead of “You are”
“I feel” – instead of “You didn’t”

Ensure privacy and allow adequate time for discussion

Pay attention to your tone of voice and body language.

Make sure your non-verbal cues match what you are
saying to the student
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 Incorporating Feedback
Let the student know:

What kind of feedback will you be giving?

Verbal? Written? Both?
When will feedback be provided?
On the fly? Right after the activity? At the end of the day?
Which activities will you provide feedback on?
Direct patient care? Case presentations? Interactions with patients? Interaction with
team members?
Who will be involved in feedback?
Other team members?
What will the student’s role be?
Students should be encouraged to take an active part to foster self-evaluation skills.
How will feedback be used in the evaluation process?
Evaluation should be a natural outgrowth of ongoing feedback – no surprises!
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 Incorporating Feedback
Give brief feedback of directly observed encounters throughout the
day with 2-3 key prioritized points.
You do not need to provide feedback on the whole encounter at one time.

Observing different parts of an encounter at different times with

different patients is more time effective.

Set aside 10-20 minutes each day to review and provide more
detailed feedback.

Write down your observations such as what the student did well and
what areas they need to develop.

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 Benefits of Feedback
Providing feedback helps you to:

Engage students in their learning.

Evaluate and modify the amount of supervision the student requires.

Recognize students’ strengths and promote independence in those

areas.

Create additional learning opportunities for students to practice skills

in areas they continue to struggle with.

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 In Summary
"Giving effective feedback requires courage, skill, understanding, and
most importantly, respect for yourself and for others." Theresa Sullivan, 2005

Feedback is an important part of the student’s learning, which

should occur regularly throughout the student’s placement.

Evaluation is a summary of the student’s learning, comparing the

student to standards and setting goals for further development.

Contact the student’s faculty advisor if you have any concerns.

Don’t leave concerns to the last day of the placement. Address

issues early with guided feedback and include the student’s school
faculty if necessary.
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 References and Resources
Branch, WT & Paranjape, A. (2002). Feedback and reflection: teaching
methods for clinical settings. Academic Medicine,77:1185-1188.
Ende J. Feedback in clinical medical education. JAMA 1983;250:777-
781.
Epstein RM. Mindful practice. JAMA 1999;282:833-839.
Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan K.
Calibrating the physician: personal awareness and effective patient
care. JAMA 1997;278:502-509.
Rider EA. Teaching medicine through student self-reflection. Focus:
Harvard Medical, Dental, and Public Health Schools 2004; February 20,
2004.
Quick Tips for Effective Feedback

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