IMPORTANCE AND

SKILLS OF GIVING
FEEDBACK
Dr Karuna Sree P
Asst. Professor
Dept. of Pharmacology
KIMS, Narketpally
 Objectives

 Define feedback
 Need for the feedback

 List out the principles of feedback

 List out the types of feedback

 Methods adapted in delivering the feedback

 Barriers of feedback
Communication to another person which gives
information about how he/she affects and is
perceived by others.
 Feed back

“Feedback refers to information describing a

learner’s performance in a given activity that
is intended to guide his/her successful
performance in that same or in a related
activity.”
- Jack Ende, JAMA, 1983
Are they similar ?

 Reinforcement
 Evaluation
 Feedback
 Feedback

 Reinforcement/Correction and explanation

 Keeps learner on course to meet goals

 Allows learner to adjust course to meet goals.

 Feedback: Goal

Support and foster students

as self-directed learners
 Objectives of Feedback
Helps learners to:
 Determine expected standards
 Identify gaps between standard and actual
performance
 Improve learning and performance

Helps teachers to:

 Adapt teaching to learners’ needs
 Keep up with learner’s progress
 NEEDS
What ought to be

What is
Learning process and Feedback
 Activity

Role Play
 Principles of feedback

Plan
Follow up Timely

Action plan Specific

Feedback
Verify Constructive

Empathize Limited &

manageable
 When to give feedback

Timing of feedback

During/soon after patient contact

End of each half day or day
Mid rotation
End of rotation
 Who can contribute?

Self
Peers
Faculty
Other team members

“360-degree feedback”
How to collect the feedback ?

 Oral
 Questionnaires
 Types of Feedback

 Constructive/positive feedback
 Negative feedback

Another type of classification:

 Brief
 Formal
 Major
How to deliver the feedback
Old feedback sandwich
New feedback sandwich
(Do ask; Do tell)

ASK
(Self reflect)

TELL

ASK
 Effective feedback
 By giving effective feedback, you will teach
others to observe, reflect, and self-correct their
own behavior and performance.

• S - specific
• O - observational
• R - relevant
• T - timely
 Checklist: The Feedback Dialogue

Ask learner to assess own performance first :

 What went well and what could have gone better?

Tell what you observed:diagnosis and explanation

 React to the learner’s observation
 Include both positive and constructive elements
 Give reasons in the context of well-defined shared goals
 Regulate quantity

Ask about recipients understanding and strategies for improvement,

 What could you do differently?
 Give own suggestions
 Perhaps even replay parts of the encounter - show me
 Commit to monitoring improvement together
 Case Scenario
 John is a very energetic learner, to the point of being
aggressive. He prepares extensively for teaching
sessions, reads exhaustively and participates actively
in discussions. In fact, he tends to monopolize
discussions often ignoring comments of his
classmates.
 In groups, discuss how and what feedback you will
give to him.
 BEFORE Giving Feedback:
Prepare Effectively

 Plan what you will say

 Is the information specific or general?
 Think about who else you need to collect
information from
 If feedback is second hand, do you have
enough specific, behaviorally based
information? Was it documented by the
other person?
 Faculty barriers to feedback

 Time constraints
 Absence of standards for competent performance
 Lack of direct knowledge of learner’s performance
 Discomfort in giving constructive (negative)
feedback
 Unfamiliar with providing effective feedback
 Learner concerns with feedback

 Non-specific - does not help learning or performance

 The comment “Keep up the good work” does not help me.

 Personal - statement about worth or potential (embarrassing

or humiliating) - more negative feedback
 Not timely - too late to change performance
 Not progressive - no sense of what they have achieved in
progress towards a goal or have yet to achieve.
 My teachers don’t provide feedback.
 Feedback seems difficult because…

 No model of effective feedback to follow

 Hurtful experience in past
 Takes time
 “Like her too much to hurt her feelings”
 May damage a relationship (friend, mentor,
etc)
 The Impact of Feedback

 Anger – “I’ve had enough of this!”

 Denial – “I can’t see any problem with that.”
 Blame – “It’s not my fault. What can you expect
when the patient won’t listen?”
 Rationalization – ”I’ve had a particularly bad week.”
“Doesn’t everyone do this?”
 Acceptance
 Renewed Action
Receiving feedback
Receiving feedback
“The important things to remember about feedback
in medical education are that

1. It is necessary
2. It is valuable
3. After a bit of practice and planning, it is not as
difficult as one might think.”
 “Without feedback, mistakes go
uncorrected, good performance is not
reinforced and clinical competence is
achieved incidentally or not at all.”
- Jack Ende, 1983