Feedback Dr.ReemAl Afari, MD.Med Medical Education Department
Objectives • Explain the difference between Evaluation and Feedback • State the 6 Stages of Feedback • State the Benefits of Giving Feedback • Learn at least one new way to facilitate effective feedback.
Questionnaire Please fill in the Pre-Workshop Questionnaire for discussion later.
Evaluation vs. Feedback Evaluation: • A systematic procedure for assessing a sample of a student’s behaviour in order to measure that behaviour against standards and norms Feedback: • The process by which the teacher provides learners with information about their performance for the purpose of improving their performance.
Why is effective feedback important? • For you as a Teacher • For the Student • For Humanity
For you 1. It is fun to teach and share ideas • It can build rapport between you and the student
For the Student 3. Improves performance 4. Giving feedback helps students establish and meet their own goals 5. Giving feedback helps teach critical appraisal of own work
For the Student 6. Giving feedback is a platform to introduce new ideas and resources 7. Without feedback, bad habits form 8. Without feedback, positive behaviors may diminish due to lack of reinforcement
For the Student 9. Generates confidence 10.Effectivefeedback promotes feelings of competence 11. Giving feedback shows students you care about them and their learning 12. It teaches them how to be good teachers
For Humanity 13. It is our responsibility to educate the next generation of HCPs 14. Feedback can inspire the next generation of HCPs
When to give feedback • After and NOT before observation • Appropriate place/setting • Appropriate time • After you have invited the student’s self-critique
Give Feedback after and NOTBefore Observation • Only give feedback on what you have observed.
2. Choose an appropriate place/setting • Quiet environment; no interruptions • Arrange seats in a neutral configuration CHOOSE THE RIGHT SETTING: • Small group: • if it will not make the student feel uneasy • Privately: • For individual feedback • Topics of a sensitive nature • In front of patient: • Only if not embarassing
3. Choose an appropriate time • Give feedback routinely • Plan a time • Ask permission: “Is this a good time?” • As close to event as possible • AFTER objectives given to student • Ideally, AFTER student feels comfortable with you • AVOID premature feedback
4. Give Feedback after you have invited the student’s self-critique • How would you ask a student for his/her self assessment?
Who should give feedback? • An observer who is: • Knowledgeable about the situation • Experienced in the clinical setting • In certain circumstances, patients can be an important source of feedback.
How to make feedback more effective The aim of giving feedback to trainees is to help them reach their potential at their particular stage of training.
To make feedback effective: • Know when. • From the person who observes the trainee. • Non-evaluative language. • Be specific, not generalized. • Focus on actions rather than personality.
To make feedback effective: • Describe or model the desired behavior • Ensure that the students understand the difference between the current and desired behavior • Develop a plan to close the gap: Educational Rx. • Follow-up on improvement
Potential barriers to effective feedback: • Fear of upsetting the trainee. • Fear of doing more harm than good. • Poor handling of the trainee’s reaction. • Lack of guidance. • Multiple resources with inadequate and inconsistent feedback. • Lack of respect for the source who gives feedback.
Pair up with your neighbour 1 person = artist; 1 person = coach Goal: To replicate a picture as accurately as possible to the original Paired Exercise • Note: Each pair will have a different picture
COACH Coach the artist to draw the picture ARTIST: You will NOT be able to look at the picture You will draw the picture purely through your coach’s instruction and feedback Paired Exercise
COACHES: Verbal Instructions Only Hands holding folder or on your lap: No hand gestures No pointing Use your feedback skills ARTISTS: Use the pencils and erasers provided You are allowed to point or gesture No peeking! Rules contd. You have 10 minutes to complete the drawing
Helping learners give feedback to each other… I’m the medical student. I don’t know what you have but Dr. Smith says it’s bad.
Helping Learners give Feedback to Each Other What are the benefits? - it prepares the student for future responsibilities - peers may have good insight into challenges - you learn when you teach - can encourage collegiality and strengthen team approach
Helping Learners give Feedback to Each Other • Provide learners with the rationale for small group critique • Ask learners to generate guidelines surrounding feedback
Guidelines for small group critique • self-critique first • give feedback directly, do not talk about a group member who is not present • say it how you would like it said to you • use examples to illustrate point • link negative observation to concrete recommendations
Helping Learners give Feedback to Each Other • Be prepared to intervene if necessary • Giver learners an opportunity to respond to critiques • Give feedback on how they are giving feedback to each other
Helping Patients give Feedback to Learners Explain to the patient prior to learner-patient encounter: • Why feedback is important • Expectations of patient • Discuss patient concerns • Reassurance of no negative consequences • Evaluation is of the learner, not the patient
Helping Patients give Feedback to Learners • Ask patient for feedback after an encounter: • Informal enquiry • Questionnaire • Videotape the patient-learner encounter • Ensure informed consent from pt • Review with pt and learner
Helping Patients give Feedback to Learners Tips for Feedback Session: • Review purpose • Review everyone’s role • Assure critique is constructive
Encourage the learner to be active in eliciting feedback from the patient: • “How did you feel when I questioned you about your eating habits?” • “Was I doing anything that made it hard for you to tell me your story?” • “Was there anything that I did that allowed you to be more open?”
The 6 Stages of Feedback • Observe student behavior • Ask the learner for their self-assessment • Describe or model the desired behavior • Ensure that the students understand the difference between the current and desired behavior • Develop a plan to close the gap: Educational Rx. • Follow-up on improvement.
Have we met the objectives? • What is the difference between Evaluation and Feedback? • What are the 6 Stages of Feedback? • What are some benefits of giving feedback (Hint: you, student, humanity) • Did you learn any new ways to facilitate effective feedback?
References • Stanford University, editor. Stanford Clinical Teaching Course. Proceedings of the Stanford Clinical Teaching Course, Stanford, California. Stanford University, 2006. • Ende J. Feedback in Clinical Medical Education. JAMA. 1983; 250(6):777-781. • Hodges B. Personal communication, 2007. The Six Stages of Feedback – The Educational Prescription Workshop. • Westberg J, Jason J. Fostering Reflection and Providing Feedback. Helping Others Learn from Experience. Springer Series on Medical Education. New York, NY.: Springer Publishing Company, Inc, 2001. • Westberg, J and Jason, J (1991) Providing Constructive Feedback. A Centre for Instructional Support (CIS) Guidebook for Health Professions Teachers. Centre for Instructional Support. Boulder, CO.
Please fill in the following: • Post-Workshop Questionnaire • Workshop Evaluation