Feedback is an integral part of growing as a clinician. We all have room for improvement, and each and every one of us is a work in progress. We all grow by having others observe us and discuss how we are doing with each of us. Giving feedback also becomes an integral part of our medical education and formal training, and it must be something we strive to become good at. Despite there being no formal training on giving feedback, these are six tips on how to give quality feedback to medical students and other trainees.
1. Be kind. In general, it is important to always be kind and thoughtful regardless of to whom you are talking. When there are power differentials, it is especially important to be kind when you are the person who has more power than the other person in the relationship. Sitting down and being very kind is important to provide a welcoming environment to the learner you are giving feedback to and training. This kindness should ideally start at the beginning of the relationship so that before discussing anything they could be good or bad at, they know that you are there for them and want to see them grow, and there are no bad feelings or thoughts of ill will toward the learner.
2. Offer to give feedback early and often. As soon as you notice something going particularly well or something going badly, give feedback to those you are training. No one can improve without feedback, and as giving feedback becomes a more normal part of the training, trainees will learn that getting feedback is a normal part of learning and growing. Feedback can be particularly uncomfortable when it is not a routine part of the education that trainees receive. Feedback should be followed up often, and the person training should feel comfortable watching the learner grow. Let the learner know that they are welcome to decline the feedback at any time at the beginning of wanting to discuss it. If there is a better time to discuss feedback, you should know about it before you begin giving feedback and know from them whether or not the conversation is welcome at that time. Maybe the learner needs to leave to go to lecture; maybe the learner is just tired and wants to go home. Allow that to be part of the conversation and know that the feedback can be given via email.
3. Start with what they do well. It can be challenging for most people to get feedback. So one of the best ways to give feedback would be to start with what someone is doing well. Be as specific as possible and discuss the implications of the impact of what they’re doing well. Examples can include talking about what a fantastic job they do about advocating for their patients and specific comments about how this has improved their patients’ lives and how this has been impactful for the patient’s experience. Ensure that this is timely and that they hear what they are doing well after rounds and that you liked how they updated their notes. This helps to form a bond between the learner and the trainer regardless of the training level and will help grow the relationship.
4. Talk about what they need to improve on. Phrasing this can make it less hurtful. Many people who go into medicine have been used to doing well in any and everything that they set their hands to. Hearing that they have an area where they need to improve can be quite jarring. However, asking if you can start giving them some feedback on areas to improve allows them to control the relationship even when they commonly do not. You can point out things that need to be improved on and continue to be as specific as you can. Tell them what you would have liked to see instead of what they did. Also, discuss their proximity to doing well; are they very close and only need to make a minor change, or do we need to redo all of the work they did?
Discuss with them a sense of partnership and that you want to continue to see them improve and that you believe that they will improve by making the changes. Discuss with them that this feedback is in no way personal.
5. Give actionable and detailed steps on how to improve. It can be challenging to know as a learner how to improve. However, it can be hard to actually be able to identify the ways to improve. Be as detailed as you can be and discuss the specific actions they need to take to improve. Sit down with them and really think about the ways to improve, and be sure to invite them to discuss and talk about this in the way it is a conversation rather than a lecture.
6. Ask for feedback on teaching. Part of being a teacher is about being able to learn and grow in ways to give feedback. Ask the learner how the feedback was and how you can get better at giving feedback. Also, ask if there is any area where they need to grow. It can be very challenging for learners to be able to give feedback, so offer to send them a link that they can fill out an anonymous survey on and provide you feedback after their grade is finalized so they feel comfortable being honest with you and so you cannot inadvertently punish them and have negative feelings about them.
Being in training is hard. Most of our learning is not standardized and is about what we hear and learn from other people as we begin and work through the training. But, with a little luck and magic, we can all become the excellent physicians and teachers we hope to be. Thinking of these tips and trips early can often work to help learners grow and keep yourself growing.
Micaela Stevenson is a medical student.
Image credit: Shutterstock.com
