Chapter 5
Giving Effective Feedback
Faculty Development Series
Madigan Army Medical Center
Tacoma, Washington 98431
Giving Effective Feedback
Chapter Contents
Group Leader Check List
Faculty Learning Needs and Resources Assessment (LNRA) and Student Feedback Survey
Attendance Sheet
Evaluation Form
Effective Feedback Background
Published literature --- Giving Effective Feedback Through Dialogue with SOME TLC
Planning the Event:
Example Eight Steps
Example Handout
Example PowerPoint Presentation Slides
SOME-TLC feedback cards (separate MS Word file)
Check List for the Group Leader
Before the Session:
___ 1.
Review background and literature on giving effective feedback.
___ 2.
Review the example eight steps of planning for this presentation.
___ 3.
Review the PowerPoint, handouts, and supporting references in this chapter.
___ 4.
Duplicate and distribute the LNRA to faculty. Return at least 5 days before the session.
___ 5.
Review the faculty LNRA prior to the session and integrate in presentation as needed.
___ 6.
Consider performing feedback survey on department learners (Residents / Students) to
share with faculty.
___ 7.
Modify the suggested eight steps, PowerPoint, and handout to fit your plan.
___ 8.
Duplicate the appropriate number of copies of the attendance roster, faculty evaluation
forms, and handouts.
During the Session:
___ 9.
Have each participant sign-in using the attendance roster.
___ 10. Distribute the handout(s) to the participants.
___ 11. Conduct the session based on your eight steps of planning.
After the Session:
___ 12. Collect the evaluation forms from the faculty.
___ 13. Keep the attendance roster for the session in your department and provide the
appropriate amount of CME to each participant.
___ 14. Consider performing post event survey (30-90 days) to assess eigth step (learning,
transfer, impact).
Example Learning Needs and Resource Assessment (LNRA)
***Consider using internet based survey systems to design and administer your surveys (Survey Monkey
for example)***
Please complete the following needs assessment for the upcoming seminar on Giving Effective Feedback
as part of your faculty development program.
The seminar will consist of an introduction by your group leader, a short PowerPoint presentation, and
small group discussions.
The purpose of this LNRA is to determine your learning needs and interests so that the seminar is most
useful for you. This needs assessment should also stimulate you to think about active learning before the
seminar begins. We need your enthusiastic participation now and during the seminar. It will be fun, and at
the end of it, we'll be asking for your feedback!
Please turn this in to your group leader (______________) no later than (_____________). Your group
leader will return this form to you at the beginning of the session.
1. Have you any formal training on how to give effective feedback? YES NO
2. What do you already know about giving effective feedback? Answer briefly below:
a. What are some characteristics of effective feedback?
1.
3.
2.
4.
b. What are some characteristics of an ineffective feedback?
1.
3.
2.
4.
3. In your experience, what are barriers to giving effective feedback?
4. What three things do you most want to learn or discuss regarding giving effective feedback?
a.
b.
c.
Example Resident / Student Feedback Survey
***Consider using internet based survey systems to design and administer your surveys (Survey Monkey
for example)***
We will be having a faculty development seminar on Giving Effective Feedback and would like your
important impute to better design our seminar.
Please turn this to the faculty POC (______________) no later than (_____________). Your group
leader will return this form to you at the beginning of the session.
1. How important is receiving feedback to you?
a.
b.
c.
d.
e.
Very Important
Important
Moderately Important
Of little Importance
Unimportant
2. In your experience, the amount of feedback you receive from faculty is:
a. Too much
b. Just right
c. Too little
3.
In your experience, the quality of feedback you receive from faculty is:
a.
b.
c.
d.
e.
Very good
Good
Acceptable
Poor
Very Poor
4. Which TWO features of feedback are most important to you?
a.
b.
c.
d.
e.
f.
g.
h.
Specific
Objective (not hearsay but something observed)
Modifiable Behaviors (focus on things that can be changed)
Expected
Timely (Right time and right place)
Limited
Constructive
Other:____________
5. List ways faculty can improve your feedback experience.
ATTENDANCE ROSTER – Page____of_____Pages
Department: ____________________
Institution:____________________
Title of CME Activity: Faculty Development Workbook Series – Giving Effective Feedback
Course Content: Didactic and Group Discussion
Instructor (Group Leader):____________________________
Date:____________ Time: Began___________ Ended________ Total ___________
Check One
Name
Rank
Staff
Physician
Resident
Physician
Total Number of Learners Attending This Activity: _________
Other
Professional
Discipline
Department or Mailing
Address
Faculty Development Session Evaluation Form
Date
Speaker
Topic
Please rate the speaker using the scale below:
Strongly
Disagree
Disagree
Somewhat
Agree
Agree
Strongly
Agree
Content was relevant to my needs
The speaker conveyed the subject matter clearly
The speaker used active learning techniques to
teach this subject
The speaker gave adequate time for questions
Audiovisual / handout material added to the
presentation
Overall, the speaker was effective
List one thing that you learned from this presentation:
Please add your comments/suggestion for improving this session on the back—they are VERY helpful
Faculty Development Session Evaluation Form
Date
Speaker
Topic
Please rate the speaker using the scale below:
Strongly
Disagree
Disagree
Somewhat
Agree
Agree
Strongly
Agree
Content was relevant to my needs
The speaker conveyed the subject matter clearly
The speaker used active learning techniques to
teach this subject
The speaker gave adequate time for questions
Audiovisual / handout material added to the
presentation
Overall, the speaker was effective
List one thing that you learned from this presentation:
Please add your comments/suggestion for improving this session on the back—they are VERY helpful.
Giving Effective Feedback
Background
"Human beings are purposeful organism who, if they know where they are supposed to be
going, and, along the way, know whether or not they are on course, will make the
necessary adjustments.” …Unknown
The term feedback was first used by rocket engineers in the 1940's. Feedback was used to "tell"
the rocket it was on course or, if off course, to guide it back onto the correct path so that it would
go where it was supposed to go (i.e., reach the predetermined end point). Feedback to maintain
the proper course and feedback to correct are equally important in guiding future performance.
Definition:
 Feedback is an objective description of performance intended to guide future
performance; the
 Process of letting others know your perceptions of their performance
 Distinct from evaluation, feedback provides information to be used to guide future
performance
 It is not a judgment
Review the characteristics of evaluation and feedback and
think about the difference. Both are critical in assuring that
your learners reach your end point and meet your standards.
Purposes of Feedback
 NOT to assess or judge provide information to be
used for improvement





Clarify deviations from an established goal
Shape behavior toward an established goal
Correct inaccurate assumptions
Motivate
Convey an attitude of concern
Learners want / need it
Characteristics of Good Feedback
 Measured against established standards
 Timely - the best feedback occurs on a day to day basis
 Constructive - it is intended to improve future performance and is given for no other
reason
 Specific - use precise and specific language
 Properly motivated - intended to improve future performance and not demean the
learner
 Directed at decision / behavior, not at the person











o Focusing on the decision allows a dispassionate dialogue with the learner
Based on personal observations and provided by anyone who is in a position to make a
valid
Observation on the learner's perform performance
Verified - assure the learner understood the message
Followed up with a plan to monitor and assist
Giving Feedback
Establish credibility / trust - this, obviously, is a long term process
Prepare - take a few moments to choose the words you will use
Confirm your motivation - feedback is given solely to improve future performance
Start with the learner's assessment - it is easier for you and more effective for the learner
Establish the "Dx" - what went well and what can be improved upon
o Gain consensus - feedback is effective if you and the learner concur on the "Dx"
Determine the "Rx"
o Ask the learner
o Gain consensus - future performance is more likely to improve if the learner
concurs with the plan to monitor and assist
Verify that the learner understands and follow up
Giving Corrective Feedback
 Credibility/trust is key: Comments must be sincere
 The learner will be receptive if she/he feels that the feedback is given with the single
purpose of improving her/his future performance
 Let the learner know it's coming
 Ask for the learner's assessment
o It is easier for you and more effective if the learner identifies areas for
improvement
 Avoid traditional P-N-P sandwich --- does not promote dialogue with learner
 Consider using new Ask-Tell-Ask-Act sandwich discussed below.
 ASARP (As Soon As Resonabily Possible). Consider emotional state of learner
 Done in private (unless it can be given in such a manner as to not be embarrassing and is
intended to guide the future performance of the other learners present)
 Try not to use "YOU" or "YOUR" (this is hard to do, but it reminds us to direct the
feedback at the performance/behavior not the person)
 Prepare - take a few moments to choose the words you will use
 Set goals for future performance
 Follow up on the plan to monitor and assist
Summary
"The goal of clinical training is expertise in the care of patients. Without feedback, mistakes go
uncorrected, good performance is not reinforced, and clinical competence is achieved
empirically or not at all." Jack Ende
The keys are the motivation of the giver (solely to improve future performance) and the
perception of the learner (that the information is provided to promote "expertise in the care of
patients").
References
 Ende J. Feedback in Clinical Medical Education. JAMA. 250(6):777-81, 1983. Excellent,
pragmatic discussion of feedback. A superb reference.
 Latting, JK. Giving Corrective Feedback: A Decisional Analysis. Social Work. Sept
1992. 37(5): 424-30. Provides a useful twelve-part feedback model.
 Osborn LM & Whitman N. Ward Attending: The Forty Day Month. University of Utah
School of Medicine. 1991. pp 119-46. Excellent resource especially for those supervising
an inpatient service.
Giving Effective Feedback Through Dialogue with SOME TLC
UFP Newsletter Section Teaching and Learning, Published Winter 2011
Kristian E. Sanchack, MD
Giving Effective Feedback Through Dialogue with SOME TLC
There is an awkward moment for that sometimes arises at the end of a procedure, clinic,
or long inpatient day. Standing before you is the learner, perhaps a resident or medical student,
with big puppy dog eyes. The eyes imply, as the student may be afraid to ask, “will you give me
some feedback?” Awareness swoops in on both of you; similar to the moment a valet drops your
bags in the hotel room. It is time for the tip. A list of excuses or transitions may flash through
your mind’s eye allowing the blissful escape from this moment. However you know that
feedback is essential. Barriers exist, but these barriers will fall way for the prepared educator.
Feedback is essential
“The goal of clinical training is expertise in the care of patients. Without feedback mistakes go
uncorrected, good performance is not reinforced and clinical competence is achieved
empirically or not at all.” –J. Endei
Feedback is the process of describing students’ performance for a given activity, for the
purpose of improvement of their knowledge, skills and attitudes. In graduate medical education
it is a key process to for the acquisition of clinical skills. Jack Ende also notes that feedback
started being described in literature as system of adjustments for rocket science. This was then
extended to the humanities through the study of cybernetics in the 1940s, as information relating
to performance was proposed to be able to change the general manner of future performance in a
process considered learning.i,ii Giving effective feedback however, does not require a degree in
rocket science or cybernetics.
Feedback occurs when a learner is given insight into what the educator observed and
what consequences or actions may follow. Evaluation and feedback may often be used as the
same term, but this not accurate, and leads to confusion. Feedback is a formative process that
should take place as a dialogue. Evaluation is summative conclusion that comes with judgment.
Feedback can not only lead to greater self-awareness for the learner, but also increase the mutual
understanding between a student and teacher.i,iii
Principles of Effective Feedback
“There is an art to giving feedback. If not done properly, or done with the wrong intention, the
student will take your comments as criticism.” W.F. Miseri
Being aware now that feedback is essential to the education process, we must review
what principles are important in giving effective feedback. Now many authors have developed
acronyms to help stimulate the memory and move forward, However, I relied heavily on my
peers, and was rewarded by Tien Bui, DO. Dr. Bui (who denies any use of mind expanding
drugs at the time) developed the memory device of SOME TLC (See Figure 1.)iv.
Figure 1. SOME TLC
S
O
M
E
T
L
C
• Specific
• Objective
• Modifiable Behavior
• Expected
• Timely
• Limited
• Constructive
Feedback should be specific. Phrases like “good job!” in themselves do not provide any
learning benefit. Instead describe precisely what was done well or not well, as well as specific
areas where they can improve.
Feedback should be objective based upon your observations as the educator.
Conversations on hearsay are less effective and reliable. Furthermore this allows a more neutral
conversation emotionally.
Focus on modifiable behaviors, particularly those that are likely to be repeated. Through
this focus you are addressing the behavior and not the person. Addressing a student concerning
the fact that as you listened to their presentation, they heavily rely on notes, had difficulty
finding labs values, and appeared like they had not prepared, doesn’t imply that you dislike them
as a person. However if you merely tell them they are “not doing great, and need to get better”
leaves them unsure as to what they should change. Over time they may feel that you are just
unfair.
Feedback should be expected. Prepare the learner for feedback sessions by informing
them ahead of time. For example at the beginning of the rotation, or work day let them know
that you will be giving them feedback. You want to avoid the blind side hit on the learner.
Consider arranging frequent scheduled feedback sessions throughout a rotation, and/or after each
procedure. Increasing the frequency decreases the amount of information to be discussed,
making it a faster task.
Even with scheduled sessions, feedback still needs to be timely. If something very
important has occurred, it should be addressed while it is fresh in everyone’s memory. It is also
appropriate to allow some extra time before addressing feedback if things are emotionally
charged, or if there is significant fatigue present in either the learner or educator.
Keep your feedback limited. Covering a large range of topics is difficult and often a
portion of what is discussed may be lost, however with frequent feedback moments that occur on
a timely basis, you can address behaviors or performance as it happens. This allows for a small
focused area to reflect on, which will allow for a more effective discussion
Finally feedback should be constructive. Your goal is to help the leaner improve, and
therefore what is discusses should occur for no other reason. While certain discussions may be
uncomfortable for a learner they should not walk away feeling insulted or demeanedi,iii,iv.
Dialogue Education
Consider the Johari Window (see figure 2.). A simple four square model which
graphically represents, what is known and unknown to self, and others. Through a dialogue, an
educator can describe what was observed, and discuss what the learner was or was not aware
occurred. Furthermore the discussion may open up areas that could not be directly observed
(student’s disclosures) and enrich the quality of training that occurs. As this dialogue occurs the
public arena where learning occurs, increases in size, and the other unknown areas shrink.v
Figure 2. Johari Window
An older method of providing feedback involved the positive-negative-positive sandwich
approach, however this can put off students. First they really don’t get a chance to disclose
anything, as it is not a conversation. Also as it occurrs they realize a “technique” is being used
so that they can be told something negative. That sandwich is not very palatable
However food is a strong visual so we can go forward with a new type of sandwich (see
figure 3.), which helps you engage in a conversation. This method uses the soft sequence of
Ask-Tell/Teach-Ask-Act.
Figure 3. New Feedback Sandwich
Consider starting your conversation asking them to assess their own performance.
Typically you could start by asking, “How do you think that went?” It is possible you will need
to probe further so consider “ What do you think went well?” or “Did you experience any
problems?” This engages the learner and improves learning through praxis; a reflection on his
action with intent to improve.
The learner may have already stated what was on your mind. If not now is an appropriate
point in which you can describe what you observed. Simple starts are “I observed…” or “ It
seemed as though…” and the classic “When you do __ I feel __” statement. It is also is
appropriate point to discuss short pearls. “In my experience…” or “Consider…” For example I
have had the benefit of the following sagely feedback:
“Kris when you present you sometimes talk to quickly, and people can’t keep up with
what you are saying. Consider taking a deep breath before starting, and consciously try to slow
down (and drink less caffeine).”
Providing some brief comments can be helpful, but the best learning occurs when the
student provides the solution. Rather than asking them to repeat your comments ask “What do
you think of my observations?” or “what will you do differently now?” and “What can we do to
improve?”
Now that you have had a good conversation relaying good feedback using SOME TLC
you are not done. The best demonstration of learning is being observed to have improved or
modified the behavior appropriately. Learning is a cycle, so trust and verify that your learner
understood. Hopefully you have gained the learners confidence in being open, and the learner
has taken away salient points that will improve patient care.
A Tastier Sandwich
With increasing restrictions on our time and our learners’ time, we need to effectively
and efficiently maximize all learning opportunities. We cannot afford to be set to broadcast
only. We must engage our students through active learning techniques. We have established
the feedback is essential. Through SOME TLC you have the framework to apply principles of
effective feedback. Using dialogue you have the ability to engage your learner in self-reflection,
as well as determine information that is unavailable to you. The ultimate goal of feedback is
clear communication. Now the awkward moments of silent expectation can be replaced with a
mutually beneficial conversation.
References
i
Ende J: Feedback in clinical medical education. JAMA 250(6):777-81, 1983
ii
Weiner N., The human use of human beings in cybernetics and society. Boston: Houghton
Mifflin Co., 1950, pg 71.
iii
Miser, W.F. The Family Physician as Teacher - Giving Effective Feedback. The Ohio Family
Physician. Vol. 51, no. 8: 12-13, 1999
iv
Luft, J. and Ingham, H. (1955) "The Johari window, a graphic model of interpersonal
awareness", Proceedings of the western training laboratory in group development. Los Angeles:
UCLA
Giving Effective Feedback
Example Eight Steps
The eight steps presented below may be used as a guide for your planning.
Modify these steps to meet your specific needs.
Who:
20 faculty learners from the Department of Family Medicine
Why:
Enhance the ability to give effective feedback as part of a required faculty
development curriculum
When:
0730-0900 on a Wednesday morning, blocked schedule for faculty development
Where:
Classroom, individual desks, accessible, AV supported, requires own computer
and sound system. Conducive to small group activities.
What:
Driven by the LNRA. Will explore characteristics of effective feedback, identify
barriers, and will discuss tools and techniques that can be used to improve
feedback giving skills.
What For:
By the end of this session, we will have:
•
•
•
•
•
How:
Reviewed importance of feedback
Defined feedback vs. evaluation
Identified barriers to feedback
Identified ingredients of effective feedback
Applied effective feedback techniques
General: Active learning: small group activities and discussion, larger group
discussion, minimal PowerPoint slides. Room contains individual desk. Will preconfigure desks into larger half-moon shape consisting of five or six learners.
Within larger half-moon configuration, will group desks in smaller half-moon
shape of two to three learners each. This will facilitate small group activities
followed larger group discussions. The session will take place at 0730, so will
provide coffee and bagels.
Induction Tasks:
1. This also serves as a “Grabber.” Play video containing funny feedback
moments in the movie industry. This will help learners draw from past
experiences. Ask group if any of these has every happened to them.
2. Ask learners to write down two or three things that come to mind when they
think of feedback. Have learners share.
3. Show result of student / resident feedback survey. Ask group to discuss
results. Where there any surprises? Are our students’ expectations and
beliefs in regards to feeback different then ours? Is there a feedback gap?
Input Tasks:
1. Learners read brief article about giving effective feedback. Have learners
highlight reasons for giving feedback, principles of effective feedback, and
ways to give effective feedback. Have learners share.
2. Feedback vs Evaluation exercise. Have learners match discriptive words with
either feedback, evaluation, or both. Show slide of our own list and ask
learners if they got something different an discuss.
3. Ask group to share their barriers to giving effective feedback. Then show
slide of LNRA response to this question. Then ask group to share possible
solutions to these barriers.
Implementation Tasks:
1. Introduce SOME-TLC acronym for giving effective feedback. Have learners
in groups of two or three pick one of feedback scenarios which discribes
events and obserations and have them highlist key points that they would want
to sue to give feedback.
2. After introducting Ask-Tell-Ask-Act feedback techique, have learners
practive giving each other feedback.
Integration Tasks:
1. Review student / resident feedback survey. How will knoweldge and skills
learned today be used to narrow or decrease gap?
2. Ask group to discuss and write down what they will do for the next month to
improve feedback to learners.
So What:
Learning: By the end of the event, learners will have demostrated knoweldge of
importance, characteristics, and skills needed to provide effective feedback. The
fact that members actively participated in discussion and generation of solutions
to feedback challenges and practiced giving effective feedback demostrates
learning.
Transfer: This will be achieved through integration tasks noted above. The key
to have each participant commit to making a change to improve how they give
feedback.
Impact: Departmental feedback to learner improves with overall improved
learning and education. This can be measured in a post event LNRA to faculty
and to students / residents.
Handout
Giving Effective Feedback:
Making a Better Sandwich
Take Home Points
•
•
•
Feedback is essential
Feedback is desired by learners
Effective feedback requires preparation
Give SOME-TLC via Ask-Tell-Ask-Act
Activity #1 – Feedback Reflection – 3 minutes
Write down 1-2 words that come to mind when you think of feedback. Share these with the
others at your table.
Be prepared to discuss any common themes that are present.
 Word #1

Word #2

Common Themes:
Activity #2 – Feedback in literature – 8 minutes
Highlight concepts of effective feedback that are important to you.
Be prepared to discuss with the group.
Giving Effective Feedback by W. Fred Miser, M.D.
The feedback we give to students should be for one primary purpose - to keep them on course
so they arrive successfully at their predetermined destination (the attainment of the skills,
attitudes and behaviors that will make them outstanding physicians).
Feedback is not "rocket science." It is an objective description of a student’s performance
intended to guide future performance. Unlike evaluation, which judges performance, feedback is
the process of helping our students assess their performance, identify areas where they are right
on target and provide them with tips on what they can do in the future to improve in areas that
need correcting.
Students will invariably say they do not receive enough feedback from us as teachers. Think
about your own training. Did your teachers let you know what you were doing right, and what
areas needed improvement? Did you receive enough feedback? Chances are your teachers let
you know when you strayed off course, but did they focus on what could be done in the future so
that you would not repeat the error? To be effective, feedback should consist of these
characteristics:
1. Good feedback should be timely. The best feedback occurs on a daily basis, not just at the
end of the rotation. If done frequently, our comments will seem less like an evaluation, and
more like helpful suggestions. Take time after an encounter or procedure to provide
feedback to the students.
2. Feedback is meant to be constructive. It is intended to improve future performance, and
should be given for no other reason. It is not meant to demean or punish the student.
Describe your observations and your own reactions.
3. The best feedback is specific. Use precise language about what specifically they did right or
what they need to do to improve. Students may momentarily feel good about themselves
when you say, "You did a good job." However, they will also wonder what specifically they
did that earned your praise. Instead of saying, "You are clumsy," provide specific feedback
such as, "The patient appeared uncomfortable when you were using the otoscope."
4. Feedback is focused on behavior, preferably ones that can be repeated, and not on the
individual. Focusing on the behavior allows a dispassionate dialogue with the student.
5. Good feedback should be based on personal observations, not on hearsay.
6. Feedback should be verified. Make sure the student understood your feedback, and then
follow up with a plan to monitor and assist the student in those areas that need correcting.
There is an art to giving feedback. If not done properly, or done with the wrong intention, the
student will take your comments as criticism. At the beginning of the rotation ask the students
how often they would like feedback, and develop a plan on providing that feedback to them.
Then, before you provide feedback, take a few moments to choose the words you will use, and
confirm your motivation that you are providing that feedback to improve their performance.
Avoid evaluative language; its use can cause the student to respond defensively.
Feedback should be done as soon as possible, unless emotions will interfere with the session.
Excellent feedback given at an inappropriate time may do more harm than good. Often after a
bad outcome, students are working through their own emotions, and are often quite critical of
their performance. At this time, brief feedback and emotional support are best, followed later by
a more detailed feedback session. Feedback should also be done in private, unless it can be given
in such a manner as to not be embarrassing. An old axiom is to "praise in public" and "critique in
private."
It is often helpful to ask the students to assess their own performance. Often they will be more
harsh about their performance, which then allows you to be more positive in your approach. It is
much easier and more effective for you if the students identify areas for improvement; you can
then help them develop a plan of action as to how they can do things differently in the future.
When assessing performance, focus on what went well, and what can be improved. Gain
consensus with the students; feedback is more effective if you and the students agree on this
assessment. Some educators advocate the P-N-P (positive-negative-positive) sandwich approach
to providing feedback. Begin with a positive statement, then give corrective feedback and
conclude with another positive assessment. However, the positive comments must be genuine, or
you will lose credibility with the student. Remember to focus on the performance and behavior,
not on the person. Also, focus on those behaviors that the student can do something about.
Reminders about shortcomings over which the student has no control only leads to frustration.
When determining a plan of action for improvement, ask the students what they can do.
Again, gain consensus with the students; future performance is more likely to improve if they
agree with the plan. It is helpful to set goals for future performance. "Next time you encounter
this, try this...," then verify that the students understand, and if the opportunity arises, confirm
that they did change their behavior.
In conclusion, Jack Ende has written, "The goal of clinical training is expertise in the care of
patients. Without feedback, mistakes go uncorrected, good performance is not reinforced and
clinical competence is achieved empirically or not at all." (Ende J: Feedback in clinical medical
education. JAMA 250(6):777-81, 1983).
We should provide feedback often to our students, helping them to stay on track so they can
achieve their ultimate goal of being outstanding physicians. It is a skill that can be developed,
and I encourage you to keep this foremost in your mind as you work with the students in your
office.
Activity #3 – Feedback versus Evaluation– 3 minutes
Using an arrow, place the descriptive words under the appropriate heading. Some words may
fall under both headings.
FEEDBACK
EVALUATION
Objective
Immediate
Scheduled
Informal
Formal
Observational
Dialogue
Monologue
Grading
Improving
Event Specific
Global Performance
Activity #4 – Cases 3 minutes
In groups of 2, each person pick one scenario. Highlight items from your scenario that you
would use to provide feedback keeping in mind SOME-TLC.
Case #1: (Medical resident scenario)
You observe a resident performing a colposcopic exam, and biopsies. The resident was
excellent in the explanation and consent of the procedure to the patient.
The patient jumps slightly during the placement of the speculum and states, “that’s
uncomfortable!” The resident repositions the speculum slightly and states “ Sometimes it is
going to hurt a little”. The resident follows the appropriate sequence of actions, identifying an
appropriate area to biopsy. As the resident continues with the procedure, the patient
intermittently makes sounds of slight discomfort when the speculum is bumped and particularly
with the biopsy.
When the resident has completed the procedure, the patient asks if she can have any
medication for pain. The resident replies stating, “colposcopy is not that painful, and you should
be fine with over-the-counter Motrin. Even that is not needed for most people.”
The resident concludes by stating he will call the patient with results, and he feels
confident that she has only minor changes, that may not require further intervention.
Case #2: (Non medical scenario)
You are teaching a class via a series of interactive workshops. Most but not all students
are there as an elective course. The curriculum requires reading between sessions. All sessions
require active participation
You note that a Mary is frequently 4-5 min late for each session. She often seems to be
poorly organized upon arrival. She is somewhat reluctant to be involved. Today during a group
session she was texting on her phone. Another student asked her to participate or leave. She
set the phone down, and returned to the activity.
When she does participate she gives insightful answers to the group. She is good at
following specific directions when engaged. However this does not occur every session. You
overhear a student stating, “Mary seems is either completely unaware that she is a drag on our
group, or she just doesn’t care.”
Activity #5 – Giving Feedback – 10 minutes
Using the items you highlighted above, practice giving SOME-TLC using the Ask-Tell / Teach Ask-Act model. Switch turns with your partner.
Be prepared to discuss with the group how your interaction went.
Activity #6 – Commitment to Improving Feedback – 5 minutes
Using what you have learned today and feedback needs of our students, list what you will do in
the next month to improve feedback to our students.
Be prepared to share.
Example Giving Effective Feedback PPT
-Script narration available on PowerPoint Presentation
*Due to animation refer to PPT for slide
clarification
*Due to animation refer to PPT for slide
clarification
*Due to animation refer to PPT for slide
clarification