How to give feedback

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What is feedback?
Feedback is an essential part of education and training programmes. It
helps learners to maximise their potential at different stages of
training, raise their awareness of strengths and areas for improvement,
and identify actions to be taken to improve performance.
Feedback can be seen as informal (for example in day−to−day encounters
between teachers and students ortrainees, between peers or between
colleagues) or formal (for example as part of written or clinical
assessment). However, ‘there is no sharp dividing line between
assessment and teaching in the area of giving feedback on learning’
(Ramsden, 1992, p. 193). Feedback is part of the overall dialogue or
interaction between teacher and learner, not a one−way communication.
If we don't givefeedback what is the learner gaining, or indeed,
assuming?
They may think that everything is OK and that there are no areas for
improvement. Learners value feedback, especially when it is given by
someone credible who they respect as a role model or for their knowledge,
attitudes or clinical competence. Failing to give feedback sends a
non−verbal communication in itself and can lead tomixed messages and
false assessment by the learner of their own abilities, as well as a lack
of trust in the teacher or clinician.
Most clinicians already give feedback to students or trainees. This
module offers some suggestions on how you can improve the feedback you
give so that you are better able to help motivate and develop
learners’ knowledge, skills and behaviours.
Why is feedbackso important in
healthcare education and training?
Feedback is important to the ongoing development of learners in
healthcare settings. Many clinical situations involve the integration of
knowledge, skills and behaviours in complex and often stressful
environments with time and service pressures on both teacher and learner.
Feedback is central to developing learners' competence andconfidence at
all stages of their medical careers.
Over the past few years, new assessment procedures have been introduced
for junior doctors. Clinical practice and professional behaviours and
attitudes are regularly and routinely assessed using a raft of
workplace−based assessments. Such tools may include multi−source
feedback, observations of clinical performance and case−based
discussions.Feedback is a critical element of all these assessments and
will involve health professionals across the board in their delivery, on
multiple occasions and throughout the training programme.
Jill Gordon (writing in 2003 about the importance and influence of
one−to−one teaching situations in clinical medicine) reinforces this,
noting that feedback is vital and that the most effective and helpfulfeedback is based on observable behaviours:
Learners value feedback highly, and valid feedback is based on
observation. Deal with observable behaviours and be practical, timely,
and concrete. The one to one relationship enables you to give feedback
with sensitivity and in private. Begin by asking the learner to tell you
what he or she feels confident of having done well and what he or shewould like to improve. Follow up with your own observations of what was
done well (be specific), and then outline one or two points that could
help the student to improve. (p. 544)
She goes on to note that one of the main purposes of feedback is to
encourage reflection:
Just as many learning opportunities are wasted if they are not
accompanied by feedback from an observer, so too are theywasted if the
learner cannot reflect honestly on his or her performance. One to one
teaching is ideally suited to encouraging reflective practice, because
you can model the way a reflective practitioner behaves. Two key skills
are (a) ‘unpacking’ your clinical reasoning and decision
making processes and (b) describing and discussing the ethical values and
beliefs that guide you in...
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