Workplace Based Assessments • Assessment Central • University of Aberdeen

Giving Effective Feedback

Feedback is a key part of workplace based assessments. Feedback is essential to help students achieve the goals of the course and to teach their maximum potential by reinforcing good behaviours and identifying areas requiring development. Effective feedback helps medical students know how they are performing and enables them to develop an action plan.

Feedback after a mini-CEX should be focused and given over around 5 minutes.

Before you Start

Place: It is best to find a private area where you can both sit down without being interrupted.

Decide what key area you will focus on when you give feedback to the student?

It is important to remember that feedback is not about you. The feedback is for the benefit of the student. It is important to explore what the student wants to get out of the feedback. This can be ascertained by asking the student prior to the assessment and at the start of the feedback.

Beginning the Feedback

Encourage the student to assess their own performance looking at their strengths as well as their weakness. Use open questions to explore any problems the student experienced during the patient encounter to help you focus your feedback on the areas the student found difficult.

Main Body of the Feedback

If an area for development is identified by the student give them space to reflect and generate ideas as to how this developmental need could be addressed before providing alternative solutions. Create a dialogue using active listening skills.
Acknowledge and reinforce good behaviour. Positive feedback can improve a student's confidence in their skills and motivates them to continue these examples of good practice.
When providing feedback be specific, descriptive and non-judgemental.
Only give feedback on directly observed performance. Describe the behaviour you saw rather than make judgements or assume know the intended outcome of the behaviour. Allow the student to recall what they were thinking and why they made a certain decision.
Check that the feedback has been understood because particularly in an anxiety provoking environment of an assessment feedback can be distorted and misunderstood by the learner.
Tip: Avoid giving unbalanced feedback.
- Some people avoid giving negative feedback so as not to upset or embarrass the student. This may give the student a false impression of competence or cause confusion due a discrepancy between marks and feedback. Most importantly focusing only on the positives does not facilitate development of the student.
- Some people focus only negative aspects of the performance this can be demoralising. Very negative feedback, particularly when it is associated with judgements can result in defensive behaviour by the student which makes it harder for the feedback to be utilised.

Concluding the Feedback

Produce a clear action plan.

This should involve examples of good behaviours that the student performed and should be continued as well as areas to develop.
The action plan is most powerful when it comes from the student so allow the student to initiate the action plan then endorse it or suggest modifications as required.
It should be SMART (specific, measurable, achievable, realistic and timed)
Tip: Avoid giving advice as this can reduce learner's self-efficacy and make them feel put down. Instead share information about what you observed. If required you could describe strategies that others have found effective in the past then let the learner decided how to incorporate this into their own development plan.

Feedback Model

There are several models of feedback. A widely used method using the Calgary Cambridge method of communication skills teaching is the SET-GO feedback method (Silverman J, Draper J., Kurtz S)

S What I Saw

E What Else I saw

T What do you Think

G What Goal are we trying to achieve

O Offers of help

The Under Performing Student:

A major responsibility of trainers is to ensure that students are competent to move onto the next level so if a student performs at a level well below that expected of them for their level of training then it is important to discuss your concerns in a supportive way. If feedback is not given until the student fails their end of year exams they will not have the opportunity to remediate the behaviour during the year. One way of transmitting this information in a supportive way is to describe the facts and state that you are concerned because you need to know that the student has key skill(s) x/y/z. So let's set a time to discuss this further with input from the year lead.