Feedback Part 2: Giving Feedback & Developing Individual Learning Plans for

Struggling Learners

Laura Hanyok, MD

Meg Chisolm, MD, Michael Melia, MD, Deepa Rangachari, MD, Bob Siliciano, MD

July 26, 2013

Objectives

• Review the key aspects of feedback• Practice delivering constructive feedback to a

learner• Practice developing a plan to improve the

learner's performance

Session Timeline

• 1:50-2:10p Feedback Overview Pt 2

• 2:15-3:10p Small group skills practice

• 3:10p Return to Large group

• 3:15-3:30p Wrap-Up

Rationale for Giving Feedback

Without feedback, mistakes go uncorrected, good performance is not reinforced, and clinical competence is achieved empirically or, not at all.

Jack Ende - Feedback in Clinical Medical Education. JAMA 1983;250:777-781.

Good Behavior is not reinforced

Mistakes GoUncorrected

Learner will make assumptions

Where Feedback Occurs

• Research Setting– Laboratory Research– Clinical Research

• Small Group or Classroom Setting• Clinical Setting– All levels of learners– All clinical areas

Where Feedback Occurs

• Research Setting– Laboratory Research– Clinical Research

• Small Group or Classroom Setting• Clinical Setting– All levels of learners– All clinical areas

Where do you deliver/receive most feedback?

The Feedback Sandwich

• Ask

• Tell

• Ask

Anatomy of a Feedback SessionBienstock, AJOG, 2007

Additional Aspects For Working with Struggling Learners

• Feedback as part of a relationship

• Ongoing Feedback Process

Feedback happens within the context of a relationship

FROM THE JOHNS HOPKINS UNIVERSITY FACULTY DEVELOPMENT PROGRAM

• Interpersonal dimensions– Establish trust & safety– Ask– Listen– Use descriptive, non-other’s perspective

• Intrapersonal dimensions– Think of yourself as a coach, not a judge– Be aware of your own feelings & assumptions– Be sensitive to and try to understand recipient’s perspective

Feedback happens within the context of a relationship

FROM THE JOHNS HOPKINS UNIVERSITY FACULTY DEVELOPMENT PROGRAM

• Interpersonal dimensions– Establish trust & safety– Ask– Listen– Use descriptive, non-judgmental language

• Intrapersonal dimensions– Think of yourself as a coach, not a judge– Be aware of your own feelings & assumptions– Try to understand recipient’s perspective– After, reflect on the encounter

Feedback happens within the context of a relationship

FROM THE JOHNS HOPKINS UNIVERSITY FACULTY DEVELOPMENT PROGRAM

• Interpersonal dimensions– Establish trust & safety– Ask– Listen– Use descriptive, non-judgmental language

• Intrapersonal dimensions– Think of yourself as a coach, not a judge– Be aware of your own feelings & assumptions– Try to understand recipient’s perspective– After, reflect on the encounter

Feedback As an Ongoing Process

• Necessary for learners to grow and to improve

• Reinforces itself the more you do it

Preparing the Learner for Ongoing Feedback

FROM THE JOHNS HOPKINS UNIVERSITY FACULTY DEVELOPMENT PROGRAM

• Determine goals/objectives • Establish rapport• Promote recipient’s elicitation of feedback• Provide ongoing feedback at regularly

scheduled intervals• Follow through

Preparing Yourself for a Feedback Encounter With a Struggling Learner

FROM THE JOHNS HOPKINS UNIVERSITY FACULTY DEVELOPMENT PROGRAM

• Collect & interpret relevant information• Decide goals for meeting & points to address• Anticipate reactions of the learner & of you• Evaluate/decide options if learner doesn’t

respond as you wish• Practice saying what you want to say• Inform learner the reason for meeting,

encourage them to prepare

A Step-Wise Approach for a Meeting with a Struggling Learner

FROM THE JOHNS HOPKINS UNIVERSITY FACULTY DEVELOPMENT PROGRAM

Open meeting effectively

Acknowledge awkwardness/discomfort

State performance issue

Elicit/listen to individual’s self-assessment/reactions

Learner Acknowledges Issue Learner Doesn’t Acknowledge Issue

Define and analyze problem Recognize/control your reactions

Problem-solve together Acknowledge learner’s perspective State your perspective

Support individual & state expectations

Decide upon actions & follow-up

Assess learner’s understanding/acceptance

Summarize & Document

Small Group Sessions: Practicing Feedback Meeting with a Struggling Learner

• Lab/Research– Room 426: Bob Siliciano

• Clinical– Room 320: Meg Chisolm – Room 326: Michael Melia

• Clinical or Small Group/Classroom– Room 420: Deepa Rangachari

• Small Group/Classroom– Room 370: Laura Hanyok

Feedback Part 2: Wrap-Up

• Thoughts from the Group– What went well?– What was more difficult?– What surprised you?

Feedback Part 2: Wrap-Up

Take Away Points• Orient learners to process of feedback• Consider the relationship• Plan/implement FB meeting process