Sunday, February 03, 2019

Giving Feedback in medical teaching

Giving Feedback

 Feedback takes place when a person is offered insight into what he actually did and the consequences of that action.
 Medical students often complain that they receive little or no feedback to guide them.
Residents can change the atmosphere of clinical education by giving feedback to the students, which can reinforce correct learning and prevent recurring mistakes, as behavioral psychology has amply demonstrated (Biehler, 1978).
 The following guidelines are recommended (Ende, 1983):

 (a) Give feed- back frequently and as soon as possible;
 (b) use first hand observation;
 (c) make feedback specific;
 (d) make feedback descriptive and informative, not judgmental.

Mistakes, widely recognized to be part of the learning process, must, of course, be corrected.
 Before criticizing a student, however, consider whether or not the student should be expected to know the answer.
 Consider also the type of mistake—intellectual versus normative, repetitive, or attitudinal.

Also consider the setting (bedside, corridor, or private conference room).
Sharply critical feedback, especially that dealing with overall performance, should be given in private in most cases, never in front of patients.

Students become more knowledgeable and skilled if they receive feed- back regularly. They are grateful to residents who give feedback and usually cooperate better with these residents.

As a general rule, feedback should not judge or evaluate the learner's intentions. It should be descriptive and limited to what was said and done or how it was accomplished. For example, "You appeared to be upset in that patient encounter. Why were you upset?" The teacher might then go on to talk about how to deal with feelings in patient encounters, how to use feelings as a signal. "After all, you are responding to something." Feedback that implies judgment or evaluation of a person's motivation or values that are personal may make students defensive. Nonetheless, feedback like this must be given in some cases, but it should be done away from others if possible. In most situations the feedback must be perceived as an ally of the learner, not as a judge. A relationship of basic trust must exist between the resident and the student.

from

Residents' Teaching Skills

edited by Janine C. Edward, PhD, Joan A. Friedland, MD, MPH, Robert Bing-You, MD, MEd, FACP

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