- Slides: 20
Using the New Feedback Sandwich to Provide Effective Feedback Faculty Development Workshop Samer Bedi, M. D. , Kathryn Fraser, Ph. D. May 23, 2012
Objectives n n n Describe rationale for giving feedback in medical education Describe common barriers to giving feedback Identify types of feedback Define characteristics of effective feedback Observe and practice giving feedback Develop an action plan for improving feedback in your own practice
Rationale for Giving Feedback in Medical Education Without feedback, mistakes go uncorrected, good performance is not reinforced, and clinical competence is achieved empirically or, not at all. Ende J. Feedback in Clinical Medical Education. JAMA 1983; 250: 777 -781.
How Do They Differ? Minimal Feedback/Reinforcement n Evaluation n Feedback n
Feedback n n (Reinforcement or correction) + Explanation Keeps you on course to meet goals Allows you to adjust your course to meet goals Given immediately after the performance or at some time soon after, when the learner still has time to demonstrate improvement
It is not a part of our culture… “What feedback? No one ever gives me feedback”.
…as it is part of other training cultures
TYPES OF FEEDBACK
Three types of feedback in medical education n Brief feedback - 2 -5 minutes n n Formal feedback - 5 -15 minutes n n On a clinical skill On a presentation, involves a dialogue Major feedback - 15 -30 minutes n Scheduled mid-point through a learning experience Branch J, Paranjape A. Feedback and Reflection: Teaching Methods for Clinical Settings. Academic Medicine. 2002; 77: 1185 -1188.
The Old Feedback Sandwich Praise Criticism Praise Is it more palatable?
The New Feedback Sandwich* Ask Tell Ask Adaptation of “The New Feedback Sandwich, ’ common in patient-physician communication literature; adapted by Lyuba Konopasek, MD, for use in feedback settings.
Limit the Quantity
Checklist: The Feedback Dialogue ü Ask learner to assess own performance first ü What went well and what could have gone better? ü Tell what you observed: diagnosis and explanation ü ü React to the learner’s observation Include both positive and constructive elements Give reasons in the context of well-defined shared goals Regulate quantity ü Ask about recipients understanding and strategies for improvement ü ü What could you do differently? Give own suggestions Perhaps even replay parts of the encounter - show me Commit to monitoring improvement together Adaptation of “The New Feedback Sandwich, ’ common in patient-physician communication literature; adapted by Lyuba Konopasek, MD, for use in medical resident feedback settings.
Do one n Role plays n Feedback on the feedback
Teach one n Request support from your co-teachers!!!
End with Ende “The important things to remember about feedback in medical education are that (1) it is necessary, (2) it is valuable, and (3) after a bit of practice and planning, it is not as difficult as one might think. ” Jack Ende, MD Ende J. Feedback in Clinical Medical Education. JAMA 1983; 250: 777 -781.