On Delivering On Delivering (And Receiving) Feedback(And Receiving) Feedback
John T. Benjamin MDThe Teaching Center
UNC Department of Pediatrics
The Teaching CenterThe Teaching Center
Teaching ThoughtsTeaching Thoughts
• “Teaching is not a lost art, but the regard for it is a lost tradition.” Jacques Barzun
• “Teachers need to be and teach learners how to be stewards for self-directedness.”
John Parboosingh MD
The Teaching Center
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Why Give Feedback?Why Give Feedback?
• An essential part of training and of measuring teaching effectiveness.
• Should encourage self-reflection, raise self-awareness; help students plan for future learning and practice keeping self-image intact.
• Can help prevent distress (burnout)
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Feedback vs. EvaluationFeedback vs. Evaluation
• These two terms are not equivalent.
• Evaluation is what is done at the end of the experience with the learner. Feedback should be happening as go along.
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2 Types of Feedback2 Types of Feedback
• Formal: scheduled; this is incorporated into the evaluations of learners.
• Informal: daily as relates to specific events: presentations, write-ups, behavior, etc.
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How often should formal How often should formal feedback occur?feedback occur?
• Learners state that doesn’t happen often
• Teachers state it occurs more often than learners think.
Recommendation:
Always label: “now you are getting feedback”
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Barriers to Giving FeedbackBarriers to Giving Feedback
• Our own feelings of inadequacy• Arranging time to do it
• Others?
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Receiving vs. Giving FeedbackReceiving vs. Giving Feedback
• Do you recognize yourself, your teachers in any of these descriptions?
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Receiving Feedback: Receiving Feedback: Learner is:Learner is:
• Negative/Closed» Disrespectful, closed, inactive listening,
rationalizing, patronizing, superficial, denies, defensive, attacking
• Positive/Open» Open, responsive, accepting, respectful,
engaged, active listening, thoughtful, interested, sincere.
• Think about feedback you have received and give examples of how you responded in each of these ways
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Giving Feedback: Giving Feedback: Teacher is:Teacher is:
• Ineffective/Negative Delivery» Vague, insensitive, disrespectful,
judgmental, general, poor timing, impulsive, selfish
• Effective/Positive Delivery» Supportive, direct, sensitive, considerate,
descriptive, specific, good timing, helpful
• Give examples of both that you have experienced
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How Do We Give Effective How Do We Give Effective Feedback?Feedback?
• Day 1 Expectations of when meet• Do it at the right time and right way• Be supportive and specific• Summarize at end and state when will occur
again
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Day 1 Clarify ExpectationsDay 1 Clarify Expectations
• “Friday will be feedback day”• Then on Friday, make sure you give each
person feedback or reschedule if you have to. You have made a commitment to do this.
• On day 1, explain why feedback is so important to have done – this motivates learners to do their best.
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Feedback: Formal Feedback: Formal 5-10 minutes a Week5-10 minutes a Week
• Organized in advance and predictable – not just when things go wrong. Private setting.
• Start by saying: This is our feedback session. • Then ask: “How do you think things are
going?” and then listen carefully.• If no response then: “What things are going
well for you? Not so well?”
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Criteria for Giving FeedbackCriteria for Giving Feedback• Given with Care• Given with
Attentive Listening• Invited by Learner• Specific• Fully Expressed
• Objective• Well-timed• Directed toward
changeable behavior
• Checked and clarified
• Evaluated
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Do not give feedback when:Do not give feedback when:
• Learner is post-call
• You are tired and/or angry at the learner
• Other responsibilities conflict with the interaction
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Do not be vague: eg don’t say:Do not be vague: eg don’t say:
• Good Job (doesn’t mean much)• You are doing great (ditto)• You did …….; you said…….; you were
disorganized……you were better at the beginning of the presentation……;
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Be as specific as you can: do Be as specific as you can: do say:say:
• Overall, I think things are going well, but:» I observed that…..» Could you clarify…. » It seems to me…..» In your presentation, it would have been
helpful if you had…..
• When would you like to meet next for a followup to this meeting?
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Giving Positive FeedbackGiving Positive Feedback
• Needs to be specific• Shows spontaneity, variety – not the same as
you gave the student before this one.• Rewards specific effort that you noticed• Provides information about competence,
value of accomplishments, progress
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Unanticipated Consequences of Unanticipated Consequences of Giving Positive FeedbackGiving Positive Feedback
• Often confirms learner’s opinion of themselves.
• You are considered omniscient• You get a good evaluation from the learner.
One faculty member said: “I am very popular with students – I give them all honors.”
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Giving “Constructive” Giving “Constructive” FeedbackFeedback
• If learner comes up with areas to work on:» Develop a plan of action which includes
rechecking with learner in a few days» Must also include areas that are going well
and emphasizing the importance of them.» Ask: “What are you going to change?”» At follow-up session, praise specific
improvement: “this is much better, because..”
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Unanticipated Consequences of Unanticipated Consequences of “Constructive” Feedback“Constructive” Feedback
• If negative enough, learner will “ding” teacher on teacher evaluation.
• Learner may not say “thank you”• Learner may not really learn much or change
their ways, but some will.• Makes you feel bad – this is not why we went
into teaching• What if learner doesn’t get it?
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Conclude FeedbackConclude Feedback
• Summarize and give a plan of action if needed.
• If problem, identify specific time to meet again in 3-4 days.
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Our JobOur Job
• Give feedback that is constructive; learners will consider it either positive or negative, but our goal is to help the learner improve and grow.
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Video of Giving FeedbackVideo of Giving Feedback
• Show video• Discuss: what did senior person do well?
What did senior person not do well?• What did learner do well?• What did learner not do well?
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Exercise - Groups of 3:Exercise - Groups of 3:1 learner, 1 teacher, 1 observer1 learner, 1 teacher, 1 observer
• Example 1. Student seems uninterested, gives poor eye contact and messes with palm pilot constantly.
• Example 2: Student shows up late and leaves early. He seems unhappy; has gotten only A’s so far.
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Exercise #2 – score sheetExercise #2 – score sheet
• Score Sheet: Observer to give feedback to the teacher; learner can add opinion as well.
• If time for a second case, rotate roles.
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Evaluation: Base on levels of Evaluation: Base on levels of Learning RIME:(Lewis First)Learning RIME:(Lewis First)
• Observer only (F)
• Reporter only (+/- P)
• Interpreter (HP)
• Manager (H)
• Educator: Resident Level
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Evaluation: Grade as a GroupEvaluation: Grade as a Group
• Issues with Honors/High Pass/Pass
• Combine forces with other attendings to come to group consensus! (example of how not to do it: Teach Attending/generalist).
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Evaluation: despite Evaluation: despite our best effortsour best efforts
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Summary and ConclusionsSummary and Conclusions
• Feedback should be given on each rotation• Day 1 – set expectations• Always be constructive and positive• Recognize: Not everyone will be ready to
hear what you have to say.
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