Transcript Promoting Feedback To Students During The Medicine Clerkship

Providing Effective Feedback
Faculty Professional Development Series
University of Pennsylvania School of Medicine
October 2004
Jennifer R. Kogan, M.D.
Lisa M. Bellini, M.D.
Department of Medicine
Workshop Objectives
• Distinguish between evaluation and feedback
• Discuss principles of effective feedback
• Identify barriers to feedback
• Identify strategies to increase feedback and improve skills
delivering feedback
Feedback
vs.
Evaluation
Feedback
• Conveys information
• Formative
• Current performance
• Neutral
(verbs & nouns)
• Foster learning
Evaluation
• Conveys judgment
• Summative
• Past performance
• Normative statements
(adjectives and adverbs)
• Certification
Benefits of Feedback
• Assist learners to:
– evaluate knowledge, practice skills
– define teachers’ expectations
– identify strengths/weaknesses without academic
penalty
– remedy deficiencies
• Assist teachers to:
– evaluate and modify coursework and teaching
– recognize student progress and achievement
Clinical Education Without Feedback
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Missed learning opportunities
Student insecurity about abilities
Inaccurate perception of performance
Disappointment and surprise with final
evaluations
Principles of
Effective Feedback
Principles of Effective Feedback
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Related to agreed upon goals
Specific
Reinforce positive outcomes and behaviors
Provide guidelines for improvement
Regulated in quantity, limited to remediable behaviors
First hand, objective information
Timely
Descriptive not evaluative language
Accompanied by explanations
Include an action plan
Ende J. JAMA. 1983; 250: 777-781
“Feedback during clinical rotations appears to
be a rather intractable problem
in medical education”
Irby DM. Acad Med 1994; 69:333-42
What Are The Barriers
To Feedback?
What Are Barriers to Feedback?
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Time constraints
Limited information about learner performance
Absence of standards of competence
Inadequate knowledge of tenets of effective
feedback
• Giving constructive feedback
• Concern about undesirable consequences for
student or teacher
Structured Approach
to Deliver Feedback
Set the Stage
 Create environment conducive to feedback
 Elicit learner’s goals beginning of rotation
 Establish expectation of continuous feedback
Start session by telling learner: “ this is your
feedback”
Conduct the Feedback Session
 Elicit learner’s self-assessment
- what was done well
- what needs improvement
 Provide feedback: positive and negative
 Check for understanding
 Develop action plan/ determine how to
monitor progress
Follow-Up
 Meet again
 Ensure action plan developed/in progress
The Feedback Sandwich
Feedback Role Plays
What Tools Can You Implement
to Increase Feedback?
Feedback Toolbox
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Mid rotation feedback forms
Read/distribute feedback article
Mini-CEX or encounter cards
Learner’s contract
Prime learners for feedback
– review tenets of feedback at orientation
– prompt students during course
– teach students how to ask for it