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Basics of Feedback

Writers make a strong distinction between feedback and evaluation. Feedback is often compared to "holding a mirror up to the learner" to emphasize that it is a formative process. Feedback provides information that the learner can use to continuously improve performance. In contrast, evaluation summarizes to what extent the learner has met the expectations of the course.

Compared to their peers, learners who receive regular feedback:

• Learn faster²
• Perform significantly better³
• Show more advanced professional judgement⁴

Without question, providing feedback is one of the most important elements of effective teaching.

Feedback is also highly valued by learners. When residents were surveyed to identify the characteristics of great teachers, providing feedback was the number two item -- second only to clinical competence!⁵ Both in this program and in national reports⁶, NOT receiving sufficient feedback is a prime complaint of learners.

If feedback is so important, popular and is a prime characteristic of a good teacher, why do we find it so awkward?

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What concerns do you have about providing feedback to learners?

The issues most frequently raised by teachers include:

• Time
• Insecurity about how to give feedback
• Concern about making the learner defensive or feel inferior
• Uncertainty that a single episode represents the learner's usual performance
• Did not think to say anything. (This usually happens when the learner is doing well and the teacher does not "state the obvious."

¹ Ende J. Feedback in medical education. JAMA 1983;250:777-781
² Hammond KR. Computer graphics as an aid to learning. Science 1971;172:903-8
³ Scheidt PC, Lazoritz S. et al. Evaluation of a system providing feedback to students on videotaped patient encounters. J Med Ed 1986;61:585-90
⁴ Wigton RS, Kashinath DP, Hoellerich VL. The effect of feedback in learning clinical diagnosis. J Med Ed 1986;61:816-22
⁵ Wolverton S, Bosworth M. A survey of resident perceptions of effective teaching behaviors. Fam Med 1985;17:106-8
⁶ Irby DM, Gillmore GM, Ramsey PG. Factors affecting rating of clinical teachers by medical students andresidents. J Med Ed 1987;55:1-7

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Community-Based Teaching Benefits - Strategies for Teaching in a Busy Practice
The Precepting Microskills - Observation and Feedback - Bedside Teaching
What is Evidence-Based Medicine? - Teaching Evidence-Based Medicine
The Ten-Minute Talk - Strategies Home Page

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