Constructive Formative & Summative Feedback

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What is Feedback?

Sometimes the best way to begin to define a concept is identify what it is not. Feedback, for example, is different than evaluation.

Evaluation tells the medical student whether they performed well or poorly, or somewhere in between. Effective evaluation should help the medical student understand the quality of their performance as judged by some agreed upon professional or academic standard. (Spear Ellinwood, 2016, RAE Feedback Course).

Feedback goes beyond evaluation. It often begins with an evaluative comment about how well the student performed, and then describes the specific conduct observed. It also explains whether and how that conduct falls within expectations, or not. In other words, feedback provides landmarks for students to be able to reflect on and improve performance. 

Constructive Feedback Is Actionable

Constructive feedback, whether formative or summative  is critical to student development.

  • Formative feedback is given at a time when the student may correct or improve their performance, prior to summative assessment (e.g., mid-block or mid-clerkship) (Schute, 2008).

  • Summative feedback is given at the closure of the learning experience (e.g., end of block, end of clerkship) and often accompanies a graded assessment (Stufflebeam & Shinkfield, 2007).

Medical students are expected to engage in practice based learning and improvement (an ACGME competency). Improvement is motivated by a desire to become proficient, develop more expertise and competence to practice medicine. But motivation is only part of the equation. Improvement is guided by self-assessment and constructive feedback from instructors and peers.

Constructive  feedback is actionable, that is, it helps the student to take action to continue excellent as well as improve behaviors, skills or attitudes.

Constructive feedback should...
  • help students understand what it is that they have done well and/or what and how they could do better.
  • promote self-reflection, that is, offer students the opportunity to self-assess - to identify strengths and recognize errors.
  • must offer guidance how to improve in order to be actionable
  • engage the learner in developing a plan for improvement.

Feedback Guides Menu

The Feedback Guides Menu contains links to several guides addressing these feedback topics:

Related Resources

 References  Resources