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To the point: medical education reviews—providing feedback

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Formative feedback is an essential component of effective teaching and learning. Without it, the learner flounders. Furthermore, the Liaison Committee on Medical Education requires formative feedback within the clerkship and specifies that students must have the time and ability to remediate deficiencies before completing the clerkship. Few articles in the medical literature address how to give effective feedback. However, the themes within these articles are consistent. Formative feedback should be an interactive activity between the teacher and learner. Feedback must be approached with mutual respect and should be provided in a safe environment. Quality feedback is timely, specific to the situation, constructive, based on direct observation and nonjudgmental. With effective feedback, learners (and teachers) can discover what to improve, as well as which behaviors and skills to reinforce and augment. Learners appreciate and request specific feedback. In addition, learners tend to rate teachers who provide feedback more highly than they rate teachers who do not provide feedback. This article in the “To the Point” series will focus on the components of effective feedback and provide a practical and effective approach to giving feedback.

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General Principles for Giving Feedback

Executing a successful formative feedback session involves attention to a few key details regarding its structure, its content, and its format. Structurally, the feedback appointment should be scheduled at the mutual convenience of both the teacher and the learner, allowing both adequate time to prepare. The meeting location should favor the student’s confidentiality. Both participants should agree on the purpose of the meeting. The content of a feedback session should be limited. The feedback

Setting the Stage for Providing Feedback—Structural Considerations

Formative feedback is provided within the broader context of the clerkship. Clerkship directors and individual faculty are therefore responsible for setting and maintaining a climate that fosters constructive professional development. Within this framework, learners should expect formative feedback sessions to occur. They should understand that such sessions are intended to promote their progress and not for establishing their grades. All parties should also understand that requests for

Setting the Stage for Providing Feedback—Content Considerations

Of course, these structural considerations simply frame the actual feedback encounter. In addition to optimizing this environment, the faculty member and the student should also take the time to independently prepare their respective content. The learner should be asked to prepare for a feedback session by assessing his/her own learning goals for the rotation both within the context of and beyond the rotation’s explicit learning objectives. The learner should reflect on how he/she is

The Feedback Encounter—The Basic Format

The overarching purpose of a formative feedback session is to help the learner improve his/her clinical performance on the rotation and to assist in his/her professional growth. At the beginning of the meeting, this purpose should be explicitly reviewed and the general structure of the ensuing feedback session outlined. This structure includes the following 4 components: (1) the student’s self-assessment, (2) the teacher’s assessment, (3) the action plan, and (4) the summary. Each of these is

Feedback “On the Fly”

Although timing and preparation are important for quality feedback, immediacy can also be highly useful. Ideally, feedback specific to a particular event or encounter should be given as close to the encounter as possible. Learners need to know that such sessions are meant to be supportive, with the goal of improving performance. Formative feedback should therefore be a regular and identifiable part of the clinical experience.

The learner should actively solicit feedback. Asking a faculty member

Conclusion

Feedback is an essential component of medical education. Unfortunately, few faculty members have received formal training in how to either give or receive feedback. Effective feedback reinforces good practice and has a motivating effect on the learner. Corrective feedback encourages learners to modify their behavior to achieve a more desirable result.10 Quality feedback depends on clear expectations for the learner, effective communication, and documentation of the encounter. By understanding

Acknowledgment

Members of the Association of Professors of Gynecology and Obstetric Undergraduate Medical Education Committee (2004-06):

Jessica Bienstock, MD, MPH, Johns Hopkins University, Baltimore, MD; Susan M. Cox, MD, University of Texas Southwestern Medical Center-Dallas, Dallas, TX; Sonya Erickson, MD, University of Colorado Health Sciences Center, Denver, CO; Eve Espey, MD, MPH, University of New Mexico, Albuquerque, NM; Alice Goepfert, MD, University of Alabama at Birmingham, Birmingham, AL; Maya

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