Feedback Sandwich |
1. Educator provides a dose of positive/reinforcement feedback. |
- Acceptable by learner as the impact of critical feedback is cushioned by the positive feedback |
- Anticipation and increased tension knowing that critical feedback will be received. |
Low |
Low |
- Micro- or macro feedback |
2. Educator provides a dose of critical/corrective feedback. |
- Highly structured and easy to apply when time is limited and during clinical activities. |
- Mostly focused on the educator, more monologue than dialogue. |
- Written or verbal, individual or group |
3. Educator provides a dose of positive/reinforcement feedback |
- Useful with passive/low-insight learners and for inexperienced educators. |
- False-positive if encounter is mostly focused on reinforcement/positive feedback. |
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Pendleton Rules |
1. Educator asks learner what was good in his or her performance. |
- Safe environment created by covering positive aspects first and then those that should be improved, from the perspective of the learner and educator. |
- Anticipation and increased tension knowing that critical feedback will be received. |
Low |
Low |
- Preferably macro- over micro-feedback |
2. Educator states areas of agreement and elaborates on good performance. |
- A dialogue is established, although highly structured. |
- Unsuitable in practice, during clinical care, but recommended in formal feedback encounters. |
- Verbal |
3. Educator asks learner what was poor or could have been improved. |
- Supports learners to initiate reflective practice and improve self-assessment skills. |
- Risk of not covering aspects to improve when time is limited. |
- Individual or group. |
4. Educator states what he or she thinks could have been improved. |
- Useful with passive/low-insight learners and for inexperienced educators. |
- The rigid structure prevents an interactive discussion and limits exploring or expanding on topics that might be relevant to the learner, risking becoming a passive recipient of suggestions, skills to develop, and action plans. |
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One Minute Preceptor |
1. Educator receives a commitment from learner (e.g., differential diagnosis, treatment plan). |
- Effective use in practice, suitable for busy or time-constrained clinical environments. |
- Variable duration of feedback encounter according to the needs of the learner and complexity of clinical case/scenario. |
Medium |
Medium |
- Micro-feedback, verbal |
2. Educator probes for supporting evidence and explores learner’s rationale. |
- Facilitates the development of clinical reasoning and decision-making skills. |
- Does not allow exploration with a great level of detail or to expand on the learner’s agenda. |
- Preferably individual over group feedback |
3. Educator teaches general rules. |
- In a few minutes, it allows the educator to explore an aspect, reinforce knowledge/skills and provide balanced feedback. |
- Unsuitable for formal feedback encounters. |
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4. Discussion with learner reinforcing what was done well. |
- Just-in-time feedback. |
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5. Discussion with learner correcting mistakes. |
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SET-GO |
1. “What did I see?” Educator asks the observed learner and group to describe the situation/scenario/performance. |
- Focuses on descriptive feedback to encourage a non-judgmental approach. |
- Not recommended for individual feedback, though some of its elements could be transferred. |
Medium to high |
Medium |
- Macro-feedback |
2. “What else did you see?” Further contributions are encouraged from the group and/or by the educator. |
- Effective when delivering group feedback. |
- Requires having enough time to involve the whole group. |
- Verbal |
3. “What do you think?” Educator encourages learner to self-assess/problem-solve. |
- Encourages peer feedback and joint problem-solving. |
- Requires supervisor group facilitation skills. |
- Group feedback |
4. “What goals are we trying to achieve?” Group discussion on outcome/objective. |
- Focuses on the learner establishing a dialogue with the supervisor and peers. |
- Unsuitable for informal feedback encounters. |
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5. “Offers on how to achieve goals.” Educator encourages group to discuss suggestions to achieve the goal. |
- Facilitates vicarious learning and reflection through the experiences of others. |
- Requires learners to develop feedback skills as the whole group is involved. |
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R2C2 |
1. Educator builds a respectful and trustful relationship and establishes rapport with the learner. |
- Effective when providing assessment- and performance-based feedback and reporting assessments. |
- Unsuitable for informal feedback encounters. |
High |
Medium to high |
- Macro-feedback |
2. Educator explores the learner’s reactions to the assessment/performance report, stimulating self-assessment and reflection. |
- Empowers learners, stimulates reflection, facilitates acceptance of assessment results and the use of the feedback. |
- Requires learners’ insight “to look” beyond the assessment results. |
- Verbal. |
3. Educator explores the learner’s understanding of the contents of the assessment/performance report and results. |
- A dialogue is established by exploring the assessment results, its value, and learner’s perception/reactions. |
- Requires a skilled educator to be non-judgmental when exploring the content and learner’s reactions to the assessment results. |
- Preferably individual over group feedback |
4. Educator adopts a coaching stance to agree on solutions and action plans. |
- Provides a framework for feedback in defensive-stance situations. |
- Enough protected time needed to explore the learner’s context/situation, and to establish rapport and a safe environment. |
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- A joint educator-learner action plan is developed in response to the assessment results. |
- Educator must be prepared for negative reactions and must fully understand the purpose and content of the assessment/performance to be reviewed. |
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ALOBA |
1. Learner is asked to reflect on and identify his or her learning needs, objectives, and agenda for the feedback encounter. |
- Priority is given to the learner’s objectives and agenda, complemented by the educator’s vision and agenda. |
- Unsuitable for informal feedback encounters, enough protected time needed. |
High |
High |
- Macro-feedback |
2. Educator encourages learner to self-assess, reflect on their situation, and problem-solve. |
- Supports learners’ self-assessment, reflection, and clinical reasoning skills. |
- Shares the disadvantages of the SET-GO model when it is used for group feedback. |
- Verbal. |
3. Educator reinforces theory-practice links and delivers descriptive and balanced feedback. |
- Established as a dialogue and interview style, where the learner is active in the skills and action plans to follow. |
- More suitable for individual than group feedback encounters. |
- Preferably individual over group feedback. |
4. Educator and learner discuss suggestions and alternatives to reach the objective and learning needs. |
- Theory-practice links are discussed. |
- Requires developed insight and reflective skills in learners so they may identify their agenda and learning needs. |
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5. Educator checks feedback acceptance, provides a summary and they agree on the action plan. |
- Focused on the learner and their needs, creating a safe environment. |
- Educator requires advanced disciplinary knowledge/skills to provide theory-practice links. |
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- A joint educator-learner action plan is developed focused on the learner’s objectives and needs. |
- Developed skills and judgement by the educator to provide balanced feedback. |
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