The Skills of Providing Constructive

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• The Skills of Providing Constructive
• Feedback

DR. MOHAMMED O. AL-RUKBAN Associate
Professor Department of Family and Community
Medicine College of Medicine, King Saud University
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Content

• Objectives
• Q1. What is the definition of feedback?
• Q2. Why feedback?
• Q3. How to conduct a feedback ?
• Q4. What is the difference between feedback and
  evaluation?

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Content

• Q5. How frequent Feedback is used in our medical
  education and why?
• Q6. Who should give the feedback?
• Q7. Where and for what behavior?
• QQQQQ?
• Summary and conclusion

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Objective...

• The aim of this presentation is to improve our
  skills of giving feedback to students and trainees

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What is feedback?
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What is feedback?
Coined in 1940s by Rocket Engineers
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What is feedback?
Feedback is a planned learning experience during
which a person who performed a task is helped to
improve his performance through emphasizing on
things done well and others that need improvement
and how?
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Why feedback?

• Think about a situation in which you received
  feedback that impacted on you.
• Was it a positive experience or a negative
  experience?
• What specifically do you remember?

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Why feedback?

• It is a very strong educational tool
• Without feedback .
• mistakes go uncorrected
• good performance is not reinforced
• clinical competence is achieved empirically or
  not at all.
• Jack Ende, Feedback in clinical medical education
  JAMA.,1983

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What Does the Research Say?

• Specific, descriptive feedback that focuses on
  success and points the way to improvement has a
  positive effect.
• (Davies, 2002)
• Clear, concise feedback matched to standards will
  promote student achievement.
• (OConnor, 2002)

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What Does the Research Say?

• Feedback generally produces positive results if
  teachers manage the form the feedback takes.
• (Marzano, Pickering, Pollack, 2001)
• Students must be given the opportunity to apply
  the feedback by trying again.
• (Black Wiliam, 1998)

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What Does the Research Say?

• The most powerful single modification that
  enhances achievement is feedback.
• The simplest prescription for improving education
  must be dollops of feedback .
• (Hattie, p 9)

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• How to conduct a feedback session?

• Trainee Things he liked or did well..
• Trainer Things they liked or did well..
• Trainee Things to improve and how?
• Trainer Things to improve and how?
• Trainer Summarizes (positive points
• specific suggestions for
• improvements)

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Feedback should be

• Timely (the most effective)

Midpoint Feedback
Feedback
Feed forward
START
END
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Feedback should be

• Timely (the most effective)
• Interactive
• Short
• Specific
• Relevant
• Non-Threatening
• Non-judgmental

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Which is more appropriate ?

• A- The antibiotic regimen chosen did not provide
  coverage for H-influenza.
• B- Your choice of the antibiotics indicates a
  lack of appreciation for the possibility of
  enterococcal infection.

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Which is more appropriate ?

• A- You were great when you presented the topic.
• B- The case presentation gave me a useful picture
  of the presenting problem

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Feedback should be

• Non evaluative
• Objective appraisal of performance
• Not an estimate of trainees personal worth.
• In a proper setting and
• Climate.
• Include Suggestions for improvement

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What is the receivers impression on Feedback?

• Adult Learners welcome feedback, especially when
  it is based on their performance and tailored to
  their goals.
• Knowles MS. San Francisco, Calif 1980.
• Feedback, even corrective type, is seen as
  helpful and highly appreciated.
• Hewson MG, Little ML. J Gen Intern Med1998.

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What is the difference between feedback and
evaluation?

• Feedback Evaluation
• Formative Summative
• Specific (not general)
• In descriptive (non evaluative) terms.
• Focus on the actions or decisions not the person
  or the decision maker.

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Commonly Rarely
How frequent Feedback is used in our institute?
Why?
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Why Feedback not used frequently?

• Not use to it.
• Failure to obtain data.
• Observations are the currency of feedback.
• Teachers avoid hurting or embarrassment.
• Damage relationship.

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Who should give the feedback?

• Anyone who is in a position to make a valid
  observation of the trainees performance and who
  is experienced enough with the clinical problem
  and the pedagogic problem.

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Who is the least able to offer Feedback?

• The person administratively in charge.
• Third hand data..
• e.g The chairman of the program
• (Dr- A) says to the resident
• Dr. B said your six months ago knowledge is
  alright but your clinical skills need more work
• ( The rotation finished around)

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Where and for what behavior?

• History
• P/E
• Case presentation
• Ward round
• progress notes..

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• TAKE HOME MESSAGES
• In most classrooms providing FEEDBACK are
  frequently underused!
• FEEDBACK is a very effective tool for a student
  and teacher to improve education.
• There is difference between FEEDBACK and
  EVALUATION.

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THANK YOU
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Further Reading

• Attached papers
• Ende J. Feedback in clinical Medical Education.
  JAMA 1983, 250.
• Ferenchick G, Simpson D et al. Strategies for
  efficient and effective teaching in the
  Ambulatory care setting. Academic Medicine
  1997,72 (4) 277-280.
• Steinert Y. Twelve tips for effective small group
  teaching in the health professions. Medical
  Teacher 1996, 18(3)203-207.
• A videotaped lecture by Dr. Basil Al Sheikh

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Further Reading 2

• Ron and Susan Zemke entitled Adult Learning
  What Do We Know For Sure in Training magazine,
  1995, volume 32(6)31-40.
• Harden RM, Crosby JR, Education Guide, The Good
  teacher is more than a lecturer. The twelve roles
  of the teacher.
• McLeod PJ, Harden RM. Clinical strategies for
  physicians. Medical Teacher 1985,7 (2)173-189
• Book titled ?? The Medical Teacher by Prof.
  Harden