Common Barriers to Good Feedback
Several barriers can prevent us from providing students with feedback. Consider whether you have ever thought any of the following:
“Students already know when they are doing a good job. I don’t need to tell them.”
We often tend to think of feedback as only addressing “negative” learner behaviors - e.g. behaviors we want to diminish. However, feedback can also reinforce students and help them to maintain positive behaviors. In order for this to happen, students must be made aware of “what” they are doing that is good.
In addition, students and instructors might have disparate reference points for good performance. Some students may overestimate their abilities, while others may be more self-critical. For example, many students constantly compare their performance to those around them. In medical education, particularly inpatient settings, they may compare themselves to more “seasoned” individuals on their teams (interns and residents) and place unrealistic expectations on themselves. Reminding students of specific things they are doing well is as important as reminding them of behaviors they can improve.
“Providing feedback is awkward and it will damage my relationship with the student.”
While providing constructive feedback can feel awkward, it can often improve relationships when it is done well. If expectations are clear from the beginning and students are given frequent feedback, there are likely to be few surprises when it is time to evaluate student performance at the end of the educational experience.
In addition, students want to feel competent. Effective feedback enhances the likelihood this will occur. Feedback lets students to understand what they are doing well and encourages them to continue these behaviors. Likewise, it identifies specific areas to address so students are able to “fix” these identified behaviors. High quality feedback therefore improves students’ performance and helps them develop competence.
However, it is important to set up a culture of feedback at the outset. Be explicit with students that feedback will be provided and discussed regularly. As a result, students are less likely to feel singled out and will instead learn to expect and solicit it as part of the “normal” experience during their rotation.