Feedback

Feedback 2017-08-10T10:56:37+00:00

Newly added content: A recent release from the Academy of Medical Royal Colleges on improving feedback.

Improving feedback and reflection to improve learning. A practical guide for trainees and trainers.

Click the adjacent link to download the PDF.

Pendleton’s rules

These can apply to a group or individual feedback on performance observed first hand or on video. They were originally written for GP trainee’s.

  1. Clarify any points of information or facts.
  2. Ask the learner what went well, ensure they identify the strengths of their performance and do not stray into weaknesses.
  3. Discuss what went well, adding your own observations.
  4. Ask the learner what went less well and what they would do differently next time.
  5. Discuss what went well and add your own observations and recommendations.

Many trainers and trainees are familiar with this model and it has both strengths and weaknesses. Do you think it works well?

“Frame-based Feedback”

There is growing recognition that cognitive biases can undermine accurate and effective feedback. This three step algorithm provides another way of giving feedback. Trainers should assume that the trainee is well intentioned and intelligent.

Step One. Tell trainee unambiguously and specifically what, from the trainer perspective went wrong or right.

Step Two. Ask questions to discover what “cognitive frames” drove the trainee’s actions. A cognitive frame is an internal image or mental model of external reality. And listen to the answer!

Step Three. Tailor instructions and discussion to the trainee’s frames. Now the trainer has uncovered the trainee’s concerns, teaching points can match the trainee’s needs.

This again is based on direct observation of a trainee

The “One minute preceptor” model

Many teaching and learning opportunities take place “on the hoof” and without a patient. Trainers can use these very short encounters to improve trainee’s experiences and this model has been shown to have a positive impact on the lack of feedback provided to many trainees.

One minute preceptor microskills reinforce what was done correctly-this provides positive feedback that builds professional self esteem and re-inforces the positive impact the action has on others.

Correct mistakes- this provides constructive feedback with feasible recommendations for improvement.

References

1. The consultation: an approach to learning and teaching.Pendleton D . OUP 2003
2. We know what they did wrong, but not why: the case for “frame-based” feedback J. Rudolph, D. Raemer, J. Shapiro. The Clinical Teacher June 2013 Vol 10, no 3 186-190.
3. Clinical teacher training; maximising the “ad hoc” teaching encounter E. Molodysky. Australian Family Physician Vol 36, no 12, 1044-1046. December 2007.