4 When do we give feedback? When a trainee undertakes a WpBA?When completing a CS report?When completing an ES report?When a trainee makes a mistake?When a trainee undertakes a procedure?When a trainee does something well?After an examination?
6 Why do we give feedback? Johari’s Window Known to self Unknown to self Known to othersOPENBLIND SPOTUnknown to othersFAÇADECLOSEDJohari’s Window
7 Why do we give feedback? Strengths Areas for development Appraisee 1 3 Appraiser24Reinforcing good practice encourages it and is motivatingCorrective feedback enables trainee to recognise consequences of their actions and encourages them to modify their actions to get a more desirable result
8 A Simple Model of Competence DoesShows howKnows howHere are the levels of competence; the next slide is how to determine where trainees areKnows
9 HIERARCHY OF KNOWLEDGE – determining the learner’s knowledgeOpen QuestionHow well have you managed this patient?What have you learnt?EvaluationIn this patient, what is the diagnosis?Is there a treatment plan?...likely outcome?AnalysisSynthesisWhat do these findings mean?A more detailed exposition. How aware are CSs of this progression?What are the causes?...effects?What do you understand by…?ComprehensionFactsWhat, when, where?
10 Adults learn best when: When clear objectives are setAnd they help set themThe learning is purposeful and structuredRelevant to their needsThey are actively involvedA variety of learning methods are usedBuilds on their previous experienceWhen feedback is givenThey engage in reflection10
11 Few trainees perceive they receive regular effective feedback Sometimes we don’t give good feedback
12 Feedback boxes on WpBAs “Read more around subject” “Do more” “More practice” “Do harder cases” “No problems” “Competent”
14 Effective FeedbackIn order to be effective it must be given and received appropriatelyGiven immediately if possible so fresh in mindBuilds on strengths and needsDescribes behaviour and impactSpecific and SensitiveInvolves the appraiseeConfronts important or difficult issuesGives guidance on rectifying behaviourIs understood and accepted by the appraiseeIs from a respected source
15 Why go over what went well? Use a positive critique‘Well done – I really liked the way you did ….’ This re-enforces good practice and encourages trainees to retain and build on the good aspects and not misinterpret this areaIncreases trainee motivation and completes the learning cycle of reflection, action planning and future repeat (improved) performance
16 Giving feedback when not so good! Trainees try to jump to this often but do positives firstRetain the positive theme by feeding back what they can do to improve, rather than what they are not good at‘In order to make that even more effective….’Focus on 1 or 2 important areas for development at a time
17 Feedback – Pendleton’s rules Clarify any points of information/fact;Ask the learner what s/he did well – ensure that they identify the strengths of the performance and do not stray into weaknesses;Discuss what went well, adding your own observations, re-enforce positives, keep to the strengths.Ask the learner to say what went less well and what they would do differently next time.Discuss what went less well, re-enforce what you agree with adding your own observations and recommendations of something you would like them to do differentlyAgree an action plan- get commitment from trainee and make sure they understood the points made
18 Effective FeedbackIn order to be effective it must be given and received appropriatelyGiven immediately if possible so fresh in mindBuilds on strengths and needsDescribes behaviour and impactSpecific and SensitiveInvolves the appraiseeConfronts important or difficult issuesIs understood and accepted by the appraisee
19 Is this a bit artificial? It can be with senior trainees so can use alternative approachStart with “Can I make a suggestion….”Give 2 reasons why you think it is a good idea: one suggesting what it would achieve and something it would prevent or solveMake an overall positive statement about the learner or their abilities“With your expertise at X this would be likely to give an excellent outcome…”
20 Feedback sandwichIf you want to make a development point eg about a step in procedure or in a busy clinicSay something positiveMake development pointHow many positive points do we need to hear to cope with a negative one?
21 Informal vs Formal Feedback Day to day in context of work activitiesFrequentDiscuss skills or specific behaviours in small dosesConsider separate planned formal feedback sessionsPrepare by collecting info from other sources tooIf we give frequent informal feedback then trainees would not complain about lack of feedbackProblems would be identified earlyStage set for progressNo surprises at formal feedback sessions
22 Practice giving feedback Notes re scenarios and role playIn 3sTraineeTrainerPeer observer
24 Make WpBAs more valuable Make sure you record the feedback givenTimely fashionMake sure trainee reflection is includedPendleton’s rulesBe focussed, specific objectivesSMARTAsk trainee to repeat the task working on those areas to show developmentAgreed action plan
25 What else to give feedback on? Think about other useful areasCommunication skills/attitudes to staff or patientsConsentDocumentationRunning a list of proceduresCoping with case loadTime managementSupervising a junior traineeQuality improvement ideas/projectsOrganising teachingChairing a meeting
26 Summary When to give feedback – All the time Why we give feedback – Encourages learningHow not to give feedbackWhat is effective feedbackWays to give feedback -Pendleton’s rulesPracticed feedback