Providing feedback to trainees Flashcards
Effective feedback includes
Clear statement of objectives
Planned time
Input from trainee
Trainee input
Often aware of strengths and weaknesses
Allows them to reflect on their performance and includes what they thought went well and opportunities for improvement
Feedback should be
3 specific points
Timely, relevant, precise, firsthand, constructive and supportive
skilled approach to feedback
identify strengths and weaknesses
effective educational strategies to encourage learning
communicate at appropriate level
clearly identify role in deliivery of supervision
refer to relevant RANZCP resources
suggest areas of improvement
clinical and educational supervision
Clinical & educational supervision is:
‘A formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, assume responsibility for their own practice and enhance consumer protection and safety of care in complex situations. It is central to the process of learning and to the scope of the expansion of practice and should be seen as a means of encouraging self-assessment and analytical and reflective skills.’ (Department of Health, 1993)
The term ‘supervision’ can have different meanings:
Clinical supervision refers to the active oversight of the day-to-day clinical work of a trainee by a senior doctor and involves ensuring that clinical decisions are safe and appropriate.
Educational supervision refers to the supervisory process where the training and mentoring of the trainee is the focus of interest. It may involve the use of clinical cases but only as the basis for teaching and learning.
aims of supervision
Clinical and educational supervision allows a doctor to:
identify solutions to clinical problems
improve standards of patient care
increase understanding of professional issues
enhance understanding of their own practice
further develop skills and knowledge.
responsibilties of a supervisor
The responsibilities of a supervisor are to oversee the clinical and educational development of a trainee by:
acting as a professional mentor
agreeing learning objectives and monitoring these
giving constructive feedback (both positive and negative)
being involved in the appraisal and assessment of the trainee.
content of supervision
The content of supervision should include:
clinical management
the trainee’s teaching experience
research experience
the needs, management and pastoral care of the trainee (
purpose of feedback
Effective feedback allows a trainee to gain insight into their progress.
It allows a comparison between the intended and the actual outcome of particular actions so that corrective action can be taken if necessary.
Feedback is essential for driving learning and ensuring that the trainee is on course to achieve their goals.
general principles of feedback
Feedback should take place within the structure of supervision.
Feedback should be based on specific, observable behaviours rather than general performance.
Feedback should be delivered in descriptive, non-evaluative and non-judgemental language.
Feedback should be limited to observable decisions and actions and not on inferences about motives.
(Hewson & Little, 1998)
Creating a respectful, friendly, open-minded, unthreatening climate.
Eliciting thoughts and feelings before giving feedback.
Being non-judgemental.
Focusing on behaviours.
Basing feedback on observed facts and specifics.
Giving the right amount of feedback.
Suggesting ideas for improvement.
Basing feedback on well-defined, negotiated goals.
two models of feedback commonly used in medicine
Pendletons rules
Calgary-Cambridge model
Pendletons rules
Pendleton’s rules:
The supervisor briefly clarifies matters of fact.
The trainee then goes first and discusses what went well with the task.
The trainer then discusses what went well from his point of view.
The trainee describes what could be done differently and makes suggestions for change.
The trainer then identifies what could be done differently and suggests options for change.
drawbacks to pendletons rules
Pendleton’s rules. These are:
The strict format can become predictable and may inhibit spontaneous discussion.
It is difficult to avoid the perception that the feedback is contrasting ‘good points’ with ‘bad points’.
The assessor may feel the opening comments become predictable and insincere.
The trainee may become defensive and the learning potential of the feedback will be reduced (Carr, 2006).
calgary-cambridge model
Agenda-led outcome-based analysis
The feedback session starts with a discussion of the trainee’s agenda.
Next, the outcome that the trainee is trying to achieve is discussed.
The trainee then proceeds to self-assessment and self problem-solving by saying how the task went.
The trainer gives feedback using the SET-GO principle (see next page).
The trainer then summarises skills necessary to achieve the outcome.
SET-GO principle
The SET-GO principle is a structured way of giving feedback:
What I Saw: Trainer describes what he saw
What Else did you see? Trainee describes what he saw
What do I Think? Trainer reflects back to the trainee what he thought about what he saw.
What Goals are we trying to achieve? Trainer revisits with the trainee as a collaborative venture what the desired outcome is.
Offers on how to achieve the goals: Suggestions regarding skills, solutions and possible rehearsals to achieve goals.
