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Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram, INDIA
Address for Correspondence:
Dr Saurabh RamBihariLal Shrivastava, 3rd floor, Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Ammapettai village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603108, Tamil Nadu, INDIA
Email: drshrishri2008@gmail.com
Constructive feedback: A step towards meaningful evaluation
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
Letter to Editor IeJSME 2013 7(2): 51
Feedback is defined as a process which comprises of communication of information followed by reactions to such communication. Feedback in medical education is an integral and important constituent of teaching as it encourages and enhances the learners’ knowledge, skills and professional performance. It aids in improvement of the performance of the learners with the basic aim of helping them achieve their goals in contrast to the
educational objectives.1
For giving an effective feedback it has to be delivered in an appropriate setting; should focus on the performance and not on the individual; should be clear & specific and based on direct observation; has to be delivered using neutral, non-judgmental language; should emphasize the positive aspects; be descriptive rather than evaluative; and should suggest measures for improvement in future. For perfect outcome, the sender and receiver of feedback should work together as a team and thus the given feedback will help in motivation and satisfaction of trainees.2
Feedback can be broadly classified in two categories – positive (constructive feedback) and negative. Constructive / positive feedback is defined as the act of giving information to a trainee through the description
of their performance in the observed situation.3
It emphasizes on the strengths of the session and areas which require improvement for the betterment. Major impact has been observed when a student compares the teacher’s / audience feedback with his own performance. The discordance between the desired and the actual performance acts as a strong motivating factor.3
Negative feedback can depress and discourage the learner and thus it is always avoided.3
Another study has categorized feedback as brief feedback (viz. given on a daily basis); formal feedback (viz. at a specified time) and major feedback (viz. provided during scheduled sessions at strategic points usually at the midpoint to the trainee / learner so that he or she can improve before the end of term.2
The process of giving and receiving feedback are skills that can be acquired only with repetitive practice. Teachers have a responsibility to provide a
meaningful feedback to learners and at the same time
learners should expect feedback and seek for the same.1
Most clinicians are familiar with the concept and principles of giving feedback but often it remains underused probably because the teacher is concerned about the impact of negative feedback upon the trainee
and upon the future trainee-trainer relationship.2
To integrate the concept of feedback in medical education, training of the trainers pertaining to techniques of adult learning and how to give feedback
to trainees it is one of the foremost requirements.4
For delivering the feedback, “feedback sandwich” method is frequently used. In this method, top slice of bread is a positive comment (viz. pertaining to what the learner has done well); the middle of the sandwich is an area which deserves improvement; and the bottom slice of bread is one more positive comment, for motivating the learner.5
Giving constructive feedback has been considered as a commitment between teachers and students for overall academic and professional
development.6
To conclude, interactive feedback is indispensable in bringing about professional development and overall improvement in doctors. In absence of adequate feedback good performance is not recognized and problems with regard to clinical competence go uncorrected for long periods of time. In view of recent changes in medical working patterns we have to create newer opportunities to observe trainees and thus provide quality & timely feedback to facilitate learning.
REFERENCES
1. Schartel SA. Giving feedback - an integral part of education. Best Pract Res Clin Anaesthesiol 2012; 26(1): 77-87.
2. Branch W T, Paranjape A. Feedback and reflection: teaching methods for clinical settings. Acad Med 2002; 77(12 pt 1): 1185-8.
3. Alves de Lima AE. Constructive feedback. A strategy to enhance learning. Medicina (B Aires) 2008; 68(1): 88-92.
4. Carr S. The Foundation Programme assessment tools: An opportunity to enhance feedback to trainees? Postgrad Med J 2006; 82(971): 576-9. 5. Milan FB, Parish SJ, Reichgott MJ. A model for educational feedback
based on clinical communication skills strategies: Beyond the “feedback sandwich.” Teach Learn Med 2006; 18(1): 42-7.
