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How to Effectively Observe and Provide Feedback
3. Levels of Feedback
Remembering that good feedback enables the learner to recognize the
implications of the information and make changes, three levels of feedback
have been described1. Each level may trigger a specific "teachable
moment" -- when the coach can provide information or insights to
help the learner improve his/her performance.
Level
of Feedback |
Description |
Example
of Feedback |
Rationale
of Feedback |
Level
1 - Reflections |
Describing
your observations to the learner without comment or any implied
value (e.g. in the case of "Reba
Rambler" |
"The
history has a great many unconnected elements" |
With
only this level of feedback and the appropriate circumstances, "Reba" may
have sufficient insight and motivation to work on a more logical
and efficient gathering and presentation
of clinical information. |
Level
2 - Reactions |
How
the preceptor reacts to the behavior. This level describes
what the observation elicits in the preceptor and is descriptive
NOT judgmental. |
"I
find it difficult to understand the principal complaint from
this information." |
This
emphasizes the importance of focusing and organizing the clinical
history and that you expect the learner to function as a colleague
helping to manage the patient. |
Level
3 - Consequences |
Preceptor
helps the learner consider the likely outcomes for the patient. |
"Getting
a good logical history really saves putting the patient
through
a lot of tests." |
|
Whatever level is used, the learner has to respond, providing the opportunity
to teach. Good feedback always leads to a dialogue with the purpose of
motivating the learner to change.
1 Society of Teachers of Family Medicine. Preceptor education project
Second Edition, Modules 3 and 6
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