How to Provide Better Feedback to Fellows

Conclusions

Feedback should be focused on growth and never be a value judgment. To create the best feedback environment, strive to create an educational alliance with your learners, promote and model a growth mindset and embrace the coaching role.

Before your next feedback session, you should consider the setting, timing, ratio of reinforcing to modifying feedback, degree of learner engagement and how often you will be giving feedback. Setting expectations with your fellows early in your time together will facilitate the incorporation of both formative and summative feedback.

You can utilize various forms of communication, such as brief nuggets of feedback (downloads) and collaborative feedback conversations (dialogues) where you can employ the “Ask, Reflect, Teach” framework.

Finally, don’t forget to solicit feedback yourself. Together, you and your fellows can create goals and action plans, and count on each other to become better teachers, clinicians and lifelong learners.

Michael Cammarata, MD, is a third-year internal medicine resident at the University of California, San Francisco (UCSF). He is an aspiring rheumatologist and clinical educator, and is applying to fellowship this academic year.

Jennifer Spicer, MD, is an assistant professor of medicine in the Division of Infectious Diseases at Emory University School of Medicine, Atlanta. She is a clinician-educator pursuing a master’s degree in health professions education with an interest in how culture impacts learning.

Geoffrey V. Stetson, MD, is an assistant professor of clinical medicine at UCSF and a hospitalist at the San Francisco Veterans Affairs Medical Center. His academic focus is on professional development for teaching in the
clinical setting. He is a member of the UCSF Academy of Medical Educators and the Association of American Medical Colleges Professional Development Committee.

References

1. Sender Liberman A, Liberman M, Steinert Y, et al. Surgery residents and attending surgeons have different perceptions of feedback. Med Teach. 2005 Aug;27(5):470–472.
2. Dweck CS. Mindset: The New Psychology of Success. Random House. 2006.
3. Telio S, Ajjawi R, Regehr G. The “educational alliance” as a framework for reconceptualizing feedback in medical education. Acad Med. 2015 May;90(5):609–614.
4. Sawatsky AP, Huffman BM, Hafferty FW. Coaching versus competency to facilitate professional identity formation. Acad Med. 2020 Oct;95(10):1511–1514.
5. Zenger J, Folkman J. The ideal praise-to-criticism ratio. Harvard Business Review. Published online March 15, 2013.
6. Chou C, Cochran N, Davis D, et al. The ART of Providing Effective Feedback. American Academy on Communication in Healthcare. 2016.
7. Watling CJ, Ginsburg S. Assessment, feedback and the alchemy of learning. Med Educ. 2019 Jan;53(1):76–85.
8. Ramani S, Könings KD, Ginsburg S, et al. Feedback redefined: Principles and practice. J Gen Intern Med. 2019 May;34(5):744–749.
9. The Accreditation Council for Graduate Medical Education and the American Board of Internal Medicine. The Internal Medicine Milestone Project. Published online 2012.
10. Olvet DM, Willey JM, Bird JB, et al. Third year medical students impersonalize and hedge when providing negative upward feedback to clinical faculty. Med Teach. 2021 Mar 3:1–15. Epub ahead of print.