What is Feedback?

“Specific information about the comparison between a trainee’s observed performance & a standard, given with the intent to improve the trainee’s performance”

 (Van de Ridder, Stokking, McGaghie & ten Carte, 2008)

Feedback needs to be:

Specific - you need to have seen the student perform the task well enough that you can provide detailed comments and know what happened

Compared to a standard - for a medical student, this will probably be the learning outcomes for that block, or Phase.

The intention is to provide constructive, timely information to the student to help them understand how they can improve their performance next time.

Why is feedback important?

Praise, punishment and extrinsic rewards are least effective at enhancing achievement. Feedback works by providing constructive, descriptive information to a learner that enables them to see the difference between their performance and the expected standard of the performance. If you say: "Well done! That was great!" your feedback is almost as effective as saying nothing, and can be less effective than saying nothing.

Which feedback model should I use?

There are many choices, here are three. You can combine them if you like.

Pendleton's Rules

• Check learner wants & is ready for feedback
• Let learner give comments/background to the material being assessed
• Learner states what was done well
• Observer(s) state what was done well
• Learner states what could be improved
• Observer(s) state how it could be improved
• Action plan for improvement is made

Be careful with this model, it can easily become a quick 'what did you do well? What can you do better?' without really digging into your student's understanding of their mistakes.

Advocacy/Inquiry

When you see a learner perform a task poorly, this method helps to challenge the learner without being critical. Pair a statement of what you saw happen (you are advocating for your point of view) for example, "I saw that you didn't check the patient's peak flow.." with a question that helps you to understand why the learner made that mistake "...and I was wondering why you hadn't done that in this patient with asthma?"

Read the reference here Link opens in a new window for the paper:

Rudolph JW, Simon R, Dufresne RL, Raemer DB. There's no such thing as "nonjudgmental" debriefing: a theory and method for debriefing with good judgment. Simul Healthc. 2006 Spring;1(1):49-55. doi: 10.1097/01266021-200600110-00006. PMID: 19088574.

ALOBA

This model is different from Pendleton's Rules and the advocacy/Inquiry method because it begins at the first meeting of teacher and learner. The first step is to ask your learner about their expectations of the session and their learning needs. By doing this, you can find out how good the learner thinks they are at something before they do a task. If they begin by saying how they need practice with a skill, you are both expecting a skill level still in development.

• Learner’s agenda –ask them what problems they experienced & what help they would like. (builds on feedback trail)
• Outcomes - what are they trying to achieve? (setting achievable but challenging goals)
• Encourage learner to solve the problems
• Include whole group
• Feedback should be:
• –Descriptive rather than judgmental
• –Balanced
• –Objective (avoid ‘Well done!’ and ‘Awful!’)

Silverman JD, Kurtz SM, Draper J. The Calgary-Cambridge approach to communication skills teaching 1: Agenda-led,outcome-based analysis of the consultation.

Educ Gen Pract 1996;4:288–299

Welcome

2 - MB ChB Degree course

3 – Assessments

4 – Phase 1

5 – Phase 2

6 – Phase 3

7 – Case Based Learning

8 – Student Engagement

9 – Student Support

10 – The Awarding Gap

11 – The Teaching Commitment

12 – ePortfolio

13 – Feedback

14 – Developing yourself as an educator