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Giving feedback

Giving feedback. Tools of the Trade 21 st November University of Leicester Dr Adrian Hastings and Dr Rhona Knight.

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Giving feedback

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  1. Giving feedback Tools of the Trade 21st November University of Leicester Dr Adrian Hastings and Dr Rhona Knight

  2. ‘Feedback or knowledge of results, is the lifeblood of learning.’ Rowntree D (1982) Educational Technology in Curriculum Development(2e). Paul Chapman Publishing, London. • Giving feedback constructively valued by junior and senior doctors Wall D and McAleer S (1999) Teaching the consultant teachers - identifying the core content. Medical education 33.

  3. Why bother with feedback? What is feedback? Key features of feedback General principles of feedback A feedback toolbox Consider the practicalities What will we cover?

  4. Why bother with feedback? What is feedback? Key features of feedback General principles of feedback A feedback toolbox Consider the practicalities

  5. Why bother with feedback? • It works: • improves learning outcomes • better marks in assessments • better results in other learning situations • deepens approach to learning • encourages active pursuit of understanding and application of knowledge • Black P and Wiliam D (1998) Assessment and classroom teaching. Assessment in Education 5:7-73. • Rolfe I and McPherson J (1995) Formative assessment: How am I doing? Lancet 385:837-9.

  6. Why bother with feedback? What is feedback? Key features of feedback General principles of feedback A feedback toolbox Consider the practicalities

  7. What is it? • ‘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.

  8. Why bother with feedback? What is feedback? Key features of feedback General principles of feedback A feedback toolbox Consider the practicalities

  9. In three groups • Task 1 • Each share a time when you received feedback that was helpful • As a group draw together some key themes of helpful feedback • Task 2 • Each share a time when you received feedback that was harmful • As a group draw together some key themes of harmful feedback • Task 3 • Identify a list of key features of effective feedback

  10. Two dimensions to feedback Support Challenge

  11. Two dimensions to feedback High support High Challenge Low Challenge Low support

  12. Two dimensions to feedback High support High Challenge Low Challenge “Good, carry on, seems to be working” Low support

  13. Two dimensions to feedback High support High Challenge Low Challenge In passing Nothing Unspecific Dismissive Low support

  14. Two dimensions to feedback High support “That was great, you’re obviously trying hard” High Challenge Low Challenge Low support

  15. Two dimensions to feedback High support Patronising General Safe High Challenge Low Challenge Low support

  16. Two dimensions to feedback High support High Challenge Low Challenge “Well that could have been done better – why did you not focus more, early on..?” Low support

  17. Two dimensions to feedback High support High Challenge Low Challenge Critical Induces defensiveness Paralysing Low support

  18. Two dimensions to feedback High support “A good effort. I could see how you were drawing the feelings out – I wonder if you got to the crux of the matter…?” High Challenge Low Challenge Low support

  19. Two dimensions to feedback High support Focused Attentive Threatening? High Challenge Low Challenge Low support

  20. Types of feedback • Brief feedback • Formal feedback • Major feedback

  21. Why bother with feedback? What is feedback? Key features of feedback General principles of feedback A feedback toolbox Consider the practicalities

  22. A selection of tools • Tool 1: Pendleton’s ‘Rules’ • Tool 2: Calgary - Cambridge • Tool 3: Non-judgemental feedback • Tool 4: Observation versus deduction • Tool 5: Pi • Tool 6: PEE • Tool 7: Unacceptable behaviour

  23. 1. Pendelton’s ‘rules’

  24. Pendleton’s ‘Rules’(Pendleton D, Schofield T, Tate P, Havelock P. The New Consultation. Oxford University, 2004.) • The learner goes first and performs the activity • Questions then allowed only on points of clarification of fact • The learner then says what they thought was done well • The teacher then says what they thought was done well • The learner then says what was not done so well, and could be improved upon • The teacher then says what was not done so well and suggests ways for improvements, with discussion in a helpful and constructive manner

  25. 2. ‘Calgary – Cambridge’

  26. SET-GO (Silverman et al.) • What I Saw • What Else did you see? • What does the learner Think? • What Goal are we trying to achieve? • Any Offers on how we should get there? SET GO

  27. ALOBA(Silverman et al.) • Agenda • Led • Outcome • Based • Analysis ALOBA

  28. 3. Non-judgemental feedback

  29. Non-judgemental feedback • Based on description • ‘Communication skills are neither intrinsically good nor bad, they are just helpful, or not helpful, in achieving a particular objective in a given situation’ • Silverman et al.

  30. Descriptive non-judgmental feedback • Aim: to support the learner and maximise learning

  31. Evaluative/judgemental The beginning was awful, you just seemed to ignore her. The beginning was excellent - great stuff!! Descriptive At the beginning you were looking at the notes, which prevented eye contact. At the beginning you gave her your full attention and never lost eye contact – your facial expression registered your interest in what she was saying. What is it?

  32. 4. Observation vs deduction

  33. Observation versus deduction • Separate behaviour and interpretation • Make interpretations tentative • I noticed at this stage that you moved more in your seat, and your face became red, I wondered if you might be embarrassed?

  34. I saw you look at your watch and thought you might be bored I saw him talking with his hand over his mouth andwondered if he was lying

  35. Behaviour Arms folded Legs crossed Flushed cheeks Rapid voice tempo Slow steady breathing Tight lips Interpretation Bored Good rapport Embarrassed Amused Disgusted

  36. 5. Pi () – Point / Illustration

  37. Pi () – Point / Illustration • Make sure that the student knows what you’re talking about! • As well as a label, give an example Point Illustration

  38. Point I’d like you to use more open questions at the beginning of the consultation. Illustration “Why not ask the patient at the beginning ‘How can I help?’” Point / Illustration

  39. 6. PEE – point / explanation / example

  40. 5. PEE – point / explanation / example • I’d like you to clarify more what the patient said. (Point) • Clarification is about checking you understand what the patient means. The patient’s understanding is not always the same as yours. (Explanation) • If the patient says she is worried something might be serious, you could clarify what she means by serious. (Example)

  41. Why bother with feedback? What is feedback? Key features of feedback General principles of feedback A feedback toolbox Consider the practicalities

  42. In groups • In what situations would you use each of these tools for feedback?

  43. A selection of tools • Tool 1: Pendleton’s ‘Rules’ • Tool 2: Calgary - Cambridge • Tool 3: Non-judgemental feedback • Tool 4: Observation versus deduction • Tool 5: Pi • Tool 6: PEE

  44. A final tool…

  45. 6. Unacceptable behaviour(eight top tips) • 1. Check person is OK before you start • 2. Use a wake-up, warning phrase: “There’s something very serious I have to say” • 3. Say, very simply, what is not right • 4. Give an example as appropriate

  46. 5. Relax the tone to allow for a positive response • usually an offer to improve ensues • 6. Respond to offer positively • but define specific, measurable outcomes • 7. Do not be drawn into discussion on: • justification of behaviour • your right to judge

  47. 8. Separate behaviour and person • Most of us take criticism better if it is not personal. • “Maybe what I did was not good – but it doesn’t mean I’m no good.” • Make sure that the student can see this distinction too.

  48. In twos • One of you is a ‘junior colleague’ • One of you is the tutor • Identify an area of bad behaviour you have had to deal with • Share it with your partner • It is the job of the tutor to address the bad behaviour described

  49. Summary...

  50. Timing Environment Appropriate Manageable TEAM Feedback Guidelines TEAM

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