EDUCATION CORNER
Expanding the Menu Beyond the Sandwich: Defining Effective Feedback By Carmen J. Martinez, MD, MSMEd, FACEP, FAAEM
Feedback is a process to provide learners with information about their performance based on direct observations. Ende defines feedback as information describing students’ or officers’ performance in a given activity that is intended to guide their future performance in that same or a related activity.1 Feedback is considered a pillar of training. It encourages and enhances the learners’ knowledge, skills and professional performance.2 There are three components necessary for effective feedback: giving feedback, receiving feedback and soliciting feedback. All three components must be present for the learner to achieve improvement. The absence of feedback can be misinterpreted as approval or can result in the learner using selfassessment.2 In addition, medical students and residents have stated that feedback, when given effectively, is useful in helping them gauge their performance and making action plans for improvement.3 Medical educators need to be well versed in the different 46
By Caroline M. Molins, MD, MSMEd, FACEP, FAAEM
ways of providing feedback, and learners should also be receptive in its many forms. This article aims to define feedback and its components and review different techniques to give feedback in medical education settings. An important first step in effective feedback is preparation. The educator must prepare the learner to receive feedback by establishing objectives, goals and expectations. The setting is also important: it should be private. In addition, feedback should be timely and frequent. The learner should receive feedback as soon as possible to give them the opportunity to remediate behaviors. It should also be based on direct observations so the teacher can give specific and descriptive examples. Lastly, another step of effective feedback is the delivery. It should clearly be labeled as feedback and should be a two-way conversation that is balanced with positive and negative comments about the behaviors that can be changed. The delivery of EMpulse Spring 2021
feedback should be modulated to the learner’s temperament, personality and generation. Furthermore, the educator must be selective of the behaviors they want to address. Focusing on one or two issues will help the learner understand the situation and how to address it without feeling overwhelmed. All of these will promote self-assessment, self-reflection and self-directed lifelong learning.4 Feedback can either be formal or informal. Formal feedback is a planned activity, such as semi-annual evaluations. Informal feedback occurs in the moment of a particular educational opportunity, such as feedback after a procedure that is completed in the clinical setting. Feedback can be discussed as being either formative or summative. Formative feedback is usually provided in real time during or directly after a specific educational moment and is focused on specific behaviors and skills. Summative feedback usually occurs
