Introduction to Evaluation

Part Two: Giving Effective Feedback

 Learning Objectives
By the end of this session, participants will be able to:
• Value their own role in giving feedback
• Learn characteristics of effective feedback
• Formulate a plan for incorporating feedback into
their teaching role
• Apply the principles of effective feedback
• Employ tools for giving feedback

Note: This is part two of a three part series. Part one is an overview of feedback and evaluation
and part three covers how to complete an evaluation.

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 What is feedback?
“…helpful information or criticism that is
given to someone to say what can be done to
improve a performance, product, etc.”

-http://www.merriam-webster.com/dictionary/feedback

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Recall from Part One: Feedback
• Reinforcement or correction with explanation
• Allows learner to make changes to meet goals
• Informs the learner about him/herself (internal)
• Informs of the learner of own progress
• Advises of observed learning needs
• Guides self-reflection and motivates improvement
• Like coaching

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 Feedback vs.
Criticism/Compliments
Feedback Criticism/Compliments
• Specific description of an • About feelings or opinions
observed behavior • Meant to make a person feel
• Meant to change a good
behavior • Meant to make a person feel
• Meant to reinforce a bad
behavior

Example: “That dress is very pretty on you.” vs. “You’ve dressed very professionally
for your presentation today.”
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 You are uniquely
positioned to have impact
As attending physicians/supervising clinicians:
• You are a longitudinal firsthand observer
• You shape a learner’s professional development
• “A preceptor can exert significant influence on the
student’s maturation from novice toward clinician.
Constructive feedback and evaluation carry
considerable weight in ensuring clinical competence.”
Ferenchick, G., Kern, D.E., Babbott, S. Evaluation and Program Enhancement. Chapter 5 Community-Based Teaching. Pgs. 89-96. 1997. ACP.

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Risks of Not Giving Feedback
• Robs trainees of valuable time to do better
• Missed opportunity for dialogue between
teachers and learners
• Undesirable/inadequate behavior continues until
intolerable- then it’s “too late”

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 Characteristics
of Effective Feedback
• Focuses on behavior over which the person has
control
• Describes the behavior
• Is given when the person is best able to hear the
feedback
• Focuses on what, not why
• Is intended to help the person perform more
effectively and reach goals

Mink O., Owen K., Mink B. Developing High Performance People, pgs. 177-178.

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 Characteristics
of Effective Feedback
• Descriptive rather than evaluative
• Specific
• Well-timed: optimally, immediately following
an observation

Whitman, N. Schwenk, T. The Physician as Teacher, 2nd Ed. Pgs. 73-76

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 Ease Awkwardness
Use the timeline
• Day One: Discuss learning objectives
• Daily: Give feedback, and note whether the
learner incorporates feedback effectively
• End: evaluate learner

Orientation Feedback Feedback Feedback Feedback Evaluation

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 Tools: Ask - Tell - Ask
• ASK - learner to assess own performance
• What went well?
• How did it go?
• TELL - what was observed: diagnosis/feedback
• ASK - about recipient’s understanding and strategies for
improvement

Presented at UNR Med by M. Bar-on created by Lyuba Konapasek, MD Weill Cornell

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 Giving Effective Feedback Using the
Same/More/Less Model

The goal is to recognize the behaviors and skillsets that

deserve recognition and should be encouraged as well
as finding methods for positive growth.

Same More Less

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• “Same as” are those traits that you value in the learner and don’t
want to lose.

• “More of” are the traits that you want to encourage. It may be a
newly acquired skill, or the beginning of a behavior, or it may be an
area where something is lacking and you want to help the learner
find a way of bridging the gap.

• “Less of” are traits that may be overused, and things need to return
to a more balanced state.

– The important thing for everyone involved to remember is what the learner
is doing well. It is not supposed to be painful for anyone.
Corporate Learning Institute (2016). Giving Effective Feedback Using the Same/More/Less Model.
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 Tools: Quadrant
Keep doing this Do more of this

Do less of this Don’t do this

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 A Sample Quadrant
Keep doing this Do more of this
“You made great eye contact during the “You should smile a little more often at
patient interview. I noticed that this built your appropriate times during the interview.”
rapport with the patient very early on, and
that they felt listened to throughout the
interview.”

Do less of this Don’t do this

“While use of silence can help draw patients “You said ‘um’ and laughed nervously
out, you had a few too many long pauses and whenever you couldn’t come up with a next
that became uncomfortable. Use this tool question. Try to pay attention during your
more judiciously.” next interview to avoid doing that.”

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 Review:
Is this good feedback?
“You said ‘um’ and laughed nervously whenever
you couldn’t come up with the next question.”

• What is good about this feedback?

• What is bad about this feedback?

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 References
1. Ferenchick, G., Kern, D.E., Babbott, S. Evaluation and Program
Enhancement. Chapter 5 Community-Based Teaching. Pgs. 89-96.
1997. ACP.
2. Mink O., Owen K., Mink B. Developing High Performance People
(Perseus Books 1993).
3. Whitman, N. Schwenk, T. The Physician as Teacher, 2nd Ed.
(Whitman Associates, 1997).

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 Questions?
Contact:
Jennifer Hagen, MD
Office of Faculty Development
jmhagen@med.unr.edu

April Heiselt, PhD

Office for Community Faculty
aheiselt@med.unr.edu