Giving Feedback Effectively

• Providing feedback is professional responsibility as a preceptor
• Create a stimulating environment where feedback is encouraged and can be successful
• Be specific!
  • Focus on observed events/issues
  • Discuss specific behaviors and suggestions for improvement
• Encourage student to provide thoughts on their own performance and areas for improvement
  • Feedback should be 2-way street!
• Overcome barriers to successful delivery of feedback
  • Be clear with goals and expectations up front
  • Make feedback regular part of each day
  • Address concerning behaviors/issues ASAP and provide meaningful solutions
  • Focus feedback on your area of expertise
  • Sandwich technique for delivery of negative feedback

• Objective and constructive sharing of observations, suggestions, and recommendations with a student
• Constructive feedback helps student identify areas where they need to make changes and improvements
• Goal of feedback is to change bad or poor behavior, reinforce good behavior, and improve skills

Good feedback is not

• Non-specific comments “Read more”: this does not help the student identify specific areas of knowledge deficits
• Harsh criticism Feedback should be constructive for it to be impactful
• Formal assessment Feedback can and should be given throughout the student’s rotation, not just at the end as part of a formal assessment

• Professional responsibility to help students improve and grow during their rotation
• Allows the student to implement change and for you to accurately assess his/her willingness to respond to feedback
• Students often appreciate feedback and feel more engaged and valued during their rotations

• Establish an environment where feedback is regularly dispensed and expected by the student
• Clearly define that you are giving feedback
  • “I’d like to give you some feedback about …”
• Prepare student for negative feedback as necessary
  • Warning shot
  • “I’d like to give you some feedback about something that is a little concerning to me”
• Propose ideas for moving forward and making improvements
  • “In the future I would like to see …”
  • “Next time...”
• Ensure that the student has a clear understanding of your expectations and educational goals you have set for them
• When giving feedback, ensure that you do this in a timely manner
  • Most impactful when given immediately after concerning event, not a week or two later
• Feedback should be given in private with minimal distractions when possible
• Base feedback on first hand observations and provide an example, do not base on hearsay
• Use non-judgmental language
  • Focus on the action and consequences rather than accusing the student of poor judgement
• Be specific and give examples
  • “Your work-up and management of patient x was problematic because…”
• Reinforce positive behaviors
  • “Your interactions with the patients and their families today was exemplary”
• Address behaviors/concerns since the last feedback
  • Do NOT perseverate on old concerns or previous mistakes unless they continue to be problematic
• Only address a few behaviors/concerns at one time
  • Attempting to address multiple issues will overwhelm the student and is not effective in prompting change on his/her behalf
• Discuss only behaviors/concerns which can be modified and improved
  • Giving feedback on fundamental personality characteristics which are not modifiable is not productive and can lead to feelings of resentment
• When possible, have the student self-assess and identify areas they feel they can improve and/or problematic decisions they have made
  • You can build off this and offer suggestions for improvement
• At end of feedback session, be sure to summarize and review next steps
  • To improve, you will do x and x by x time
    • Arrange for follow-up as necessary
      • Build in time to review progress either at a set time or mid-way through the rotation
      • “Let’s come back to this again in 1 week to discuss your progress in implementing these changes we have just discussed”

• Uncomfortable with confrontation
  • Sandwich technique
    • Start and end with positive feedback, negative feedback given between positive comments
  • Mentally rehearse the discussion until comfortable discussing with the student
  • Speak to Marquette PA Program representative for further insight
• Belief that things will improve on their own
  • Rarely is this the case
• Student has a “difficult” personality
  • Focus on the behavior, not the person
    • “Your style of interaction was taken offensively by the listener, which I’m sure was not your intention” vs “You’re being rude”
  • Ask the student to self-assess to see if they understand the issue
  • Reach out to the PA program if you have serious concerns about a student’s personality and ability to function at a professional level
  • Goal is to improve behaviors and skills, not to change basic personality characteristics
• Angry/Sad/Defensive student
  • Reframe the negative feedback
    • Encourage that change will result in a positive outcome for the student in their future interactions with patients/staff/etc.
  • Give the student time to process the information and re-address later
  • Keep the conversation on track and specific
    • Focus on specific areas of change and expected results
• Timing
  • Make feedback a regular and expected occurrence
    • Schedule specific day/time if necessary
  • Address issues when they arise and are fresh, often only takes a few minutes of time and impact can be significant
  • Keep feedback brief by focusing on 1-2 specific behaviors/events and what the student can do differently next time
• Uncertain about own knowledge base
  • Focus feedback on what you are comfortable with in medical knowledge, communication, professionalism, and practice management
  • Model behavior for student
    • Look up information together
    • Encourage student to look up independently and meet at future designated time to review together
    • Get help from consultant service
      • Demonstrates how to handle a complicated situation when you are unsure of what to do