July 19, 2021

Giving learners high-value feedback​

Bruce Peyser, MD, FACP
Director of Education and Teaching, Duke Primary and Urgent Care
Physician, Duke Primary Care Pickett Road

Professor of Medicine, Duke University School of Medicine

One of the most challenging things we do as clinician-educators is given good feedback to our learners. The reason for this, I believe, is due to a combination of factors.

Feedback can be delivered in a variety of ways. Sometimes we sit with our learners and give them feedback based on what we observed while working with them earlier in the day. We watch and listen and analyze, and we observe things that deserve positive encouragement, support, and coaching. This part of providing feedback is fun because I think we all want to be able to tell another person they are doing a good job and explain the reasons why that is the case.

A more difficult aspect of giving feedback occurs when something needs to change or an aspect of the learner’s work requires improvement. When this happens, we know this corrective type of feedback is received and processed more effectively when the observations are discussed in person, and not when either individual is rushed or distracted. If I am sitting with a student and I know there is an aspect of their work that requires change, I will usually first ask them what they think about their work. Oftentimes, our students are aware of their weaknesses, and it’s easier to broach a sensitive topic if the learner has already identified it.

Another instance of giving feedback occurs when we write our comments, typically at the middle or end of a rotation. This type of feedback is more summative; it’s based upon a series of observations that have taken place over a period of days, weeks, or even months. Before composing my written comments, I prefer to meet in person with the learner, and I often find their insights and impressions to be quite helpful. Certainly, what is written at the end of a rotation can be critical for the student, as it serves as a gauge for both learner and course leadership. Recorded observations provide a way for assessing student progress and comparing to peers. Also, written comments may be used later by academic deans when they compose letters of recommendation for students applying for residency positions.

There is a tremendous learning module, called “Best Practices for Precepting and Assessing Learners,” that can help refine the way you observe and comment upon your learners’ actions and behaviors in the clinic. If you work with learners on a regular basis, I strongly urge you to spend time working through the module (and there is no quiz at the end!). It is very granular, detailed,​ and easy to follow.

If you complete the module (which should not take more than 15 minutes), you will find it easier to know what sort of comments are most helpful to your students.

The provision of high yield feedback is not easy. It takes practice, experience, and attention to detail. But when your oral and written comments become more focused, granular, and informative, you become a more highly valued educator who can have a significant influence upon learners. I urge you to take the time and energy to improve upon your feedback skills, as detailed information is often a most appreciated gift that you bestow upon your learners.​

To access the “Best Practices for Precepting and Assessing Learners” module, open Duke’s Learning Management System, and enter the course name or ID (00154712) in the catalog search bar. Click the “search” button, then choose the course from the search results.