residents as teachers loyola university medical center stritch school of medicine graduate medical...
TRANSCRIPT
Residents as TeachersLoyola University Medical Center
Stritch School of Medicine
Graduate Medical Education
Session 2
The Fine Art of Feedback
Intended Learning Outcomes
Describe giving, receiving, and soliciting feedback in more detail
Explain the interactions between giving, receiving, and soliciting feedback
Identify barriers that prevent effective feedback
Learn advanced techniques for giving, receiving, and soliciting feedback
How do you know you’re doing a good job?• “When you don’t call me into your office, I must be
doing a good job.”• “I must be doing okay because there haven’t been
any speeches about patient safety lately.”• “I must be doing okay because you always tell me
when I make too many errors.”• “When you don’t send my reports back, I know I’m
doing a good job.”• “When you don’t look at me and shake your head, I
know I’m doing a good job.”
Giving Feedback
Receiving
Feedback
Soliciting
Feedback
“Lip service”
“Demotivation”
“Justification”
Feedback Triad
Why Use Feedback?
• Learners who get effective feedback:– do significantly better– develop better judgment– learn faster
• Learners rate feedback as one of the most important qualities of a good teacher
• Most learners want more feedback on their clinical skills
• Feedback helps everyone
Arts & Crafts
What is the main reason you do not get feedback more often?
How do you typically react when receiving feedback?
What’s the main reason why you don’t solicit feedback more often?
First, teachers need to undertake effective instruction…
…Feedback is what happens second
Before Giving Feedback
Have you communicated your expectations?
Have you asked how the learner wants to get feedback?
Have you conducted an orientation?
Have you probed learner’s knowledge, skills, and abilities?
Have you checked learner’s experience?
Two Types of Feedback
• Informal– Spontaneous– Unplanned– Brief
• Formal– Scheduled– Planned– More time
Feedback Triad
Giving Feedback
Receiving Feedback
Soliciting Feedback
Definition of Giving Feedback
Specific information provided by another source with the intent to improve performance or understanding
The art of observation (of actions) and description (of outcomes)
Activity
• Think about the most recent time you received feedback from a teacher
What was the event/situation?
What specifically did they tell you?
How did you take it?
• Write your answers on the
index card provided
Levels of Giving Feedback
TASK How well tasks are understood and/or performed
ProcessThe main process needed to understand and/or perform tasks
Self-Regulation
Self-monitoring, directing, and regulating of actions
SelfPersonal evaluations and affect (usually positive) about the learner
Feedback Techniques
Ask learner how she/he wants feedback
Based on direct observation
Ask learner for focused self-assessment
Describe what you saw
Feedback Techniques
Make the feedback very focused• Specific behavior amenable to change
• Effectiveness/outcomes of behaviors
• Actions not inferences
• Value to receiver
Develop joint action plan
Follow-up
ActivityFind a partner
30 seconds to:Think of something you like about your partner’s outfit
One way the outfit could be improved
Each partner tells what you like about the outfit, then says “but” then tell how the outfit could be improved
Now repeat what you just said to your partner with the word “and” instead of “but”
Formal or Corrective Feedback
Think it through firstControl your emotions
Anticipate reaction
Private settings
Explain the reason for the feedbackFocus on actions/behaviors
Supported by objective examples and direct observation
Stay calm, use conversation voice
Formal or Corrective Feedback
Actively listen to responses
Clarify any misunderstandings
Plan to move forward
“Giving” Review
Set a good foundationTeaching, expectations, orientation
Focus the feedback
Learner self-assessment
Describe what you saw
Going forward
Where am I going?
How am I doing?
Where to next?
Feedback TriadGiving Feedback
Receiving Feedback
Soliciting Feedback
Information Sender
ReceiverEnvironment
• Timely• Video/Written/ Verbal• Goal – oriented• Specific• Descriptive• Action plan
• Credibility• Characteristics• Behavior• Delivery• Respect• Expertise• Direct observation• Objective
• Mentally ready• Fits goals/objectives• Useful• Personal health• Self-perception• Prior KSA• Motivation
PerceptionFilter
• Private/Public• Outpatient/Inpatient/OR• Individual/Group
Receiving Feedback
Activity
Need a volunteer
WarningNo physical strain or pain
May be mental anguish or feelings of resentment
Effects won’t last more than 10 minutes
Receiving Feedback
Will it help you obtain your goal?
Listen to everything said—don’t interrupt
Don’t defend, contradict, argue, or interrogate
Ask for clarification if needed
Accept it as one bit of data
Feedback TriadGiving Feedback
Receiving Feedback
Soliciting
Feedback
Feedback Rich Environment
Mutual accountability
Willingness to learn
No fear
No surprises
Truthfulness
Self-responsible language
Coaching
Soliciting Feedback: Receiver
Request feedback early
Highlight exactly what you are looking for
Choose specific people
Make sure it is directly related to your goals
Use helpful opening phrases (“I think I missed the patient’s reaction. What do you think?”)
Ask for recommendations
Never compare the feedback from others openly
Thank them for the information
Decide what to do with their input
Consider it as a single data point
If you do use the feedback, tell them
Soliciting Feedback: Sender
Create a supportive atmosphere
Realize the person is asking for guidance, not criticism
Clarify what the person wants feedback on
Listen to their self-assessment and respond accordingly
When finished, ask if that was what they wanted to know
Respond with respect
Help the person create an action plan: don’t tell them what to do
Follow up in the future
Barriers to Giving Feedback
“The learners already know how they’re doing.”
“I don’t have time.”
“That must have been an anomaly.”
“I’m not used to this. I feel awkward.”
“Learners get defensive.”
“The learner isn’t ready to receive feedback.”
“Who/what do I compare them to?”
Take Home Points
Giving FeedbackTeach first
Be focused
Receiving FeedbackActive listening
A single data point
Soliciting FeedbackAsk specifically
Ask when you’re ready to receive