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EFFECTIVE FEEDBACK PRINCIPLES & SKILLS. Definition:. ‘A two-way process in which an educational supervisor or group appropriately share with the learner information based on observation, with the aim of reaching a defined goal.’ Knight R. The Good Consultation Guide for Nurses, Radcliffe 2006.
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Definition: • ‘A two-way process in which an educational supervisor or group appropriately share with the learner information based on observation, with the aim of reaching a defined goal.’ • Knight R. The Good Consultation Guide for Nurses, Radcliffe 2006.
What is Feedback? • “Feedback is not about praise or blame, approval or disapproval. That’s what evaluation is – placing value. Feedback is value-neutral. It describes what you did and did not do.” ~ Grant Wiggins
Is it important? • Learners want and value feedback. • Identify learner needs, accelerate learning and offer option for future performance. • Encourages learners to be actively engaged and take responsibility for their own learning.
Able to recognize, evaluate and discard or include new ideas in practice. • Provides information about current performance. • Models for learners that ongoing feedback and continual learning are part of clinical medicine.
Why Feedback Is Often Avoided or Neglected: • No experience of providing constructive feedback or instruction on how to do it. • Previous experience that emphasized negative feedback based on humiliation and fear. • Fear of damaging close relationships between teachers and learners. • Time-consuming
Rationale for Giving Feedback • 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
Characteristics of effective feedback: • Specific and timely. • Focused on observed behaviors that can be changed. • Non-judgmental. • Balance between positive and negative that provide encouragement. • Sharing ideas and information rather than giving advices.
Step 1: • Briefly clarify any points of information maters of fact.
Step 2: • Ask learner to discuss “ What went well?”
Step 3: • Discuss what went well, adding your own observations. If there is a group, ask them “What went well?”
Step 4: • Ask the learner to identify and discuss "What did not go well?” and “ What could be done differently next time?”
Step5: • Discuss what went less well, adding your observations and recommendations. If there is a group, ask them to do the same.
Pendleton Rules questions: • What do you think you did well? • What do I think you did well? • What could have done differently? • What do I think you could have done differently? • How do you feel about this • Finish on a positive reinforcement
Some strengths of Pendleton's Rules • Offers the learner the opportunity to evaluate their own practice and allows even critical points to be matters of agreement. • Allows initial learner observations to be built upon by the observer(s). • Ensures strengths are given parity with weaknesses. • Deals with specifics.
Some difficulties with Pendleton's Rules • It is not easy to separate strengths and weaknesses. Though it sets out to protect the learner, it is artificial. • Feedback on areas of need is held back until part way through the session, although learners' may be anxious and wanting to explore these as a priority. This may reduce the effectiveness of feedback on strengths. • Holding four separate conversations covering the same performance can be time consuming and inefficient.
