Feedback Theory & Strategies

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What is feedback?

Educators offer feedback to learners to help them improve “knowledge and skill acquisition,” as well as motivate learning (Schute, 2008). Thus, to be effective, feedback should always be constructive (helpful).  

Feedback tells the medical student how they performed and why their performance is considered good, poor or otherwise. In other words, feedback offers the factual basis and the instructor’s rationale for their evaluation of the student’s performance. Feedback, then, should be constructive (i.e., formative) whenever it is given.

How is feedback different from 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. Often educators intend for their statements to serve as feedback, but the statements are more accurately characterized as evaluation.

Constructive Feedback is Always Formative

Giving 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 a particular learning experience (e.g., end of block, end of clerkship) (Stufflebeam & Shinkfield, 2007).

​Given that medicine involves lifelong learning, your summative feedback should be formative, anticipating the learner's next educational experience and increasing professional responsibilities.

Feedback Should Include Actionable Guidance

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.

Constructive feedback...

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

  • Describes relevant, observable behaviors, and offers students the opportunity to self-assess - to reflect on their performance, identify strengths and recognize errors.

  • Offers guidance or  suggestions for improvement and engages the learner in developing a plan for improvement.

  • Guides the learner in carrying out their plan for improvement.

Related Resources

Guide References CME Reflective Feedback