What are your learners' QUALITY-related feedback concerns?
*This multi-part series describes ten common learner feedback complaints and how to identify which ones underlie your learner's feedback concerns.
The first type of learner feedback complaint is about the QUALITY of feedback they receive. These concerns speak to the “what” or content of the feedback provided. Learners may offer comments about:
What’s being shared or not shared in feedback (e.g. specific topics, tips)
Whether the feedback is too heavily focused on positive or negative comments (e.g. they say the feedback is "too critical "or they are getting "empty praise")
The learner's opinion of the feedback's value or usefulness (e.g. whether the feedback recipient thought the feedback could help them grow or address a learning gap)
How can you determine if your learners' feedback concerns are QUALITY-related?
Quality concerns are one of the most frequently mentioned complaints in the feedback scholarship, with trainees often reporting, “I’m not getting good or useful feedback.”
In addition to providing a judgment of the value or usefulness of the feedback they receive, they may share specific comments about what feedback they find unhelpful or helpful. These may include:
"My feedback was too general."
"The attending only gave me negative comments. Surely, I must have done something right."
"The faculty pointed out what I did wrong but didn't offer advice about how to do it correctly."
“I asked my attending how to improve a technique I am struggling with. They told me to read more articles.”
“My attending said, ‘Good job.’ That was it.”
“It’s helpful when faculty share teaching points about cases they are interested in. I would like to see more of these”
“It would be nice to receive a text of encouragement now and then.”
How to increase the QUALITY of your feedback.
1. Make it specific. Provide details about why a specific behavior or action was or was not effective. “Good job” can be good for the ego, but is less helpful for encouraging ongoing progress and growth.
Instead of, “Stop interrupting the patient,” try: “When you were taking the patient’s history, I noticed that you started a few questions before the patient had finished their response to the previous question. When this happens, we run the risk of missing out on vital information and run the risk of coming off as dismissive to the patient. In the future, I recommend counting to 2 after a patient stops talking before moving on to the next question.”
2. Make it descriptive. Focus on the behavior or actions (not the person). When people feel attacked, they often go into defensive mode and shut down or shut off their listening and reasoning skills. By focusing on the person’s behaviors or actions (which can be modified) rather than the person’s character or personality (which are more difficult to change), you increase the likelihood that the learner will be receptive to and possibly appreciate your feedback.
Instead of, “You were really rude to that nurse,” try: “I noticed that you seemed to be looking at your phone and talking with the resident next to you when the nurse started talking.”
3. Make it actionable. In the thick of a moment–especially when we are being evaluated–our stressed brain misses out on hints or implied messages. Include explicit instructions about whether to continue doing a specific action or behavior. If you advise the learner to stop a specific action or behavior, be sure to introduce a new action to use in its place. If the person can walk away with a strategy or action plan, they are more likely to perceive the feedback as being useful.
Instead of, “Don’t do that again,” try: “In the future, I ask that you excuse yourself if you need to take a phone call.”
4. Focus on strengths and weaknesses. Many educators think that their job is to point out the flaws. However, learners benefit from recognition of their strengths as well. A simple acknowledgment of positive behaviors or actions can be useful feedback, especially if the learner is actively working on improving that skill or lacks confidence in their ability in that area. You don’t have to offer strengths at every feedback discussion but aim to identify strengths at some point.
Instead of, “Here is a list of things you have done wrong,” try: “Here is one strength and one growth opportunity.”
5. Make it timely. While this is focused more on when the feedback is delivered, many learners complain that a piece of high-quality feedback is “useless” because it arrived too late for them to be of use. If you notice a concern early in the rotation, share that feedback as close to the encounter as is reasonable (using the other tips as well) so the learner can apply that feedback and practice the skills for a longer period.
Instead of writing on the end-of-rotation evaluation, “The resident is always late to rounds,” try telling them: “I noticed you arrived late to the last two rounds. I want to make sure you start this rotation on the right foot and ask that you arrive by 7:00 a.m.”
Join the Conversation
What two QUALITY-related feedback complaints do your learners (or you) make most frequently? Share your comment or ask a question below.
What if the feedback issue is not QUALITY-related?
Maybe your learners’ feedback concerns aren’t about what feedback is offered, but rather how much feedback is offered. In the next post, I will discuss QUANTITY-related feedback concerns and how to spot them.
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