School of Medicine Resident Teaching Skills

Teaching Resident Physicians to Be Educators

BEST Module 4: Giving Feedback

Bringing Education & Service Together (BEST) is an interdisciplinary service learning project for resident physicians

Learning Outcomes

By the end of this module, residents will be able to:

  1. Administer constructive feedback to learners.
  2. Explain the INSIGHT approach to feedback.
  3. Employ effective feedback techniques.

The INSIGHT Approach to Giving Feedback

Inquiry
  • How does the learner think things are going?
  • Listen to the learner’s needs in detail.
  • Listening attentively and thoroughly before commenting may be all you need to do, especially for minor/temporary problems.
Needs
  • What does the learner feel s/he needs during this rotation?
  • Ask the learner to define own learning needs.
  • Learners accept feedback better when they feel the teacher has first understood their perspectives.

Specific

  • Give your constructive feedback as specifically as you can.
    • Start with specific positive feedback.
      • The more learner-centered the feedback, the better it will go.
  • Verify the learner’s understanding of the feedback you’ve given.
Interchange
  • How can you best balance the learner’s needs with the team’s needs?
  • You may need to think creatively to find a mutually satisfying solution
Goals
  • State any new goals you’ve just reached, or review existing goals.
  • Verify that you both understand and agree on these goals.
Help
  • Do any serious problems merit a learning consultation?
    • Chief resident
    • Attending physician
    • Learning specialist
    • Employee assistance program
    • Others
Timing
  • Any final questions or comments?
  • When would you and the learner like to meet again to go over how things are going?

Feedback Tips

Based on trust

  • The best feedback is based on trust. We tend to reject feedback if we don’t trust the messenger to feel like they have some kind of agenda.
  • For feedback to be effective, you must build credibility and rapport. The student must understand and accept that the feedback is for their own good.

Explain impact

  • Point out the direct results of the behavior on the patient or practice. Using statements such as I noticed or It made me feel are difficult to argue with. You avoid devolving into a debate about why it was done in a certain way.

Judgmental vs. Descriptive language

  • Avoid language that makes a judgment. Use language that describes a specific, observable behavior. Then, explain why that behavior was good or why it was a problem depending upon the circumstance.

Deduction vs. Observation language

  • Comments like "You don’t seem comfortable with older patients" is a deduction. You are deducing from what you have observed, but you can’t know what caused the behavior; you are only guessing. Instead, try using language that focuses on what you observed. For example, "I noticed that when you interviewed that older patient, you failed to make eye contact or use his name."

Focus Forward

  • Give small actionable items for next time. Ideally only one or two. That will end the discussion on a positive note and give the student something to focus on that they can control, rather than obsessing over the critique.