1. Introduction to Evaluation
Part Two: Giving Effective Feedback

2. Learning Objectives
By the end of this session, participants will be able to:
Value their own role in giving feedback
Learn characteristics of effective feedback
Formulate a plan for incorporating feedback into their teaching role
Apply the principles of effective feedback
Employ tools for giving feedback
Note: This is part two of a three part series. Part one is an overview of feedback and evaluation and part three covers how to complete an evaluation.

3. What is feedback?
“…helpful information or criticism that is given to someone to say what can be done to improve a performance, product, etc.” -

4. Recall from Part One: Feedback
Reinforcement or correction with explanation
Allows learner to make changes to meet goals
Informs the learner about him/herself (internal)
Informs of the learner of own progress
Advises of observed learning needs
Guides self-reflection and motivates improvement
Like coaching

5. Feedback vs. Criticism/Compliments
Specific description of an observed behavior
Meant to change a behavior
Meant to reinforce a behavior
Criticism/Compliments
About feelings or opinions
Meant to make a person feel good
Meant to make a person feel bad
Example: “That dress is very pretty on you.” vs. “You’ve dressed very professionally
for your presentation today.”

6. You are uniquely positioned to have impact
As attending physicians/supervising clinicians:
You are a longitudinal firsthand observer
You shape a learner’s professional development
“A preceptor can exert significant influence on the student’s maturation from novice toward clinician. Constructive feedback and evaluation carry considerable weight in ensuring clinical competence.”
Ferenchick, G., Kern, D.E., Babbott, S. Evaluation and Program Enhancement. Chapter 5 Community-Based Teaching. Pgs ACP.

7. Risks of Not Giving Feedback
Robs trainees of valuable time to do better
Missed opportunity for dialogue between teachers and learners
Undesirable/inadequate behavior continues until intolerable- then it’s “too late”

8. Characteristics of Effective Feedback
Focuses on behavior over which the person has control
Describes the behavior
Is given when the person is best able to hear the feedback
Focuses on what, not why
Is intended to help the person perform more effectively and reach goals
Mink O., Owen K., Mink B. Developing High Performance People, pgs

9. Characteristics of Effective Feedback
Descriptive rather than evaluative
Specific
Well-timed: optimally, immediately following an observation
Whitman, N. Schwenk, T. The Physician as Teacher, 2nd Ed. Pgs

10. Ease Awkwardness Use the timeline Day One: Discuss learning objectives
Daily: Give feedback, and note whether the learner incorporates feedback effectively
End: evaluate learner
Orientation
Feedback
Feedback
Evaluation

11. Tools: Ask - Tell - Ask ASK - learner to assess own performance
What went well?
How did it go?
TELL - what was observed: diagnosis/feedback
ASK - about recipient’s understanding and strategies for improvement
Presented at UNR Med by M. Bar-on created by Lyuba Konapasek, MD Weill Cornell

12. Giving Effective Feedback Using the Same/More/Less Model
The goal is to recognize the behaviors and skillsets that deserve recognition and should be encouraged as well as finding methods for positive growth.
Same
More
Less

13. “Same as” are those traits that you value in the learner and don’t want to lose.
“More of” are the traits that you want to encourage. It may be a newly acquired skill, or the beginning of a behavior, or it may be an area where something is lacking and you want to help the learner find a way of bridging the gap.
“Less of” are traits that may be overused, and things need to return to a more balanced state.
The important thing for everyone involved to remember is what the learner is doing well. It is not supposed to be painful for anyone.
Corporate Learning Institute (2016). Giving Effective Feedback Using the Same/More/Less Model.

14. Tools: Quadrant Keep doing this Do more of this Do less of this
Don’t do this

15. A Sample Quadrant Keep doing this
“You made great eye contact during the patient interview. I noticed that this built your rapport with the patient very early on, and that they felt listened to throughout the interview.”
Do more of this
“You should smile a little more often at appropriate times during the interview.”
Do less of this
“While use of silence can help draw patients out, you had a few too many long pauses and that became uncomfortable. Use this tool more judiciously.”
Don’t do this
“You said ‘um’ and laughed nervously whenever you couldn’t come up with a next question. Try to pay attention during your next interview to avoid doing that.”

16. Review: Is this good feedback?
“You said ‘um’ and laughed nervously whenever you couldn’t come up with the next question.”
What is good about this feedback?
What is bad about this feedback?

17. References
Ferenchick, G., Kern, D.E., Babbott, S. Evaluation and Program Enhancement. Chapter 5 Community-Based Teaching. Pgs ACP.
Mink O., Owen K., Mink B. Developing High Performance People (Perseus Books 1993).
Whitman, N. Schwenk, T. The Physician as Teacher, 2nd Ed. (Whitman Associates, 1997).

18. Questions? Contact: Jennifer Hagen, MD Office of Faculty Development
April Heiselt, PhD
Office for Community Faculty