How Attending Physicians Can Give Fellows Valuable Feedback

7. Recognize the destructive power of negativity: Unfortunately, teaching isn’t all appreciation and feel-good moments. In deeply distressing moments, attendings must lay down the law. In such situations, I take a very cautious approach. Often, nonjudgmental feedback can prove just as effective as heavy-handed condemnation. Of course, it requires more effort and dedication to develop a relationship with a challenging learner to ensure I can deliver feedback effectively, but this approach typically works better than furthering conflict.

Throughout my residency and fellowships, I’m sure I received a thousand nice words from attendings, but I remember the few inconsiderate, judgmental criticisms most of all. I never accepted those judgments, and even though I was forced to show changes in my behavior, this harsh approach ultimately proved unsuccessful. I continued my habits, occasionally secretively, and sought to avoid interacting with such attendings. Now, as an attending, I keep that lesson in mind when I must address such situations.

These past few months have provided me a fresh perspective on feedback. But regardless of the position, feedback is feedback. Yes, attendings may have an added responsibility of ensuring fairness and equality, but ultimately, attendings benefit from upholding a culture of high-quality feedback. After all, attendings are learners, too, and fellows, residents and students have a lot to teach us. When delivered correctly, feedback dignifies and destigmatizes this role reversal.

Admittedly, this approach can prompt a sense of apprehension among certain faculty members who see weakness in losing control and hard power over their learners. But gaining learners’ esteem and respect strengthens the educational environment and the attendings’ status as venerable teachers.

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Bharat Kumar, MD, MME, FACP, RhMSUS, is a clinical assistant professor of internal medicine at the University of Iowa in Iowa City. He completed a dual fellowship in rheumatology and allergy/immunology, and a master’s in medical education in 2017. He has special interests in journalism, health­care policy and ethics. Follow him on Twitter @BharatKumarMD.