Feedback
bull Feedback in education bull Feedback is information about lsquothe gaprsquo between the actual level of displayed
learning and the reference level of learning (Ramaprasad 1983)
bull Has been considered in literature for around for about 100 years
bull Behaviorist theory (Thorndike 1913)bull Positive reinforcement (Positive feedback)
bull Punishment (Negative feedback)
bull Not all feedback is effective or recognised
Importance of Feedback
ldquoClinical teachers should regard the art of giving feedback as a critical skill to be acquired through repeated practice and augmented by reflection on their own performancerdquo
(Cantillon amp Sargeant 2008)
Why is Feedback Important
bull Good performance is not reinforced and poor performance remains uncorrected
bull If a teacher makes no comment trainees may assume that all is well
bull Learners may have to rely on unreliable hearsay from colleagues and administrators to get the feedback they so desperately need
bull Learners may have to guess their level of competence based on how well they are coping
bull Learners may have to learn by trial and error at patientsrsquo expense
Power of Feedback
bull Formative Feedbackbull The power comes from the double approach of addressing both cognitive and
motivational domains bull Cognitive Gives information that allows them to understand where they are in their
learning and what to do next
bull Motivational Allows students to develop a feeling of control over their own learning
bull Good feedback contains information that the student can use however they must be able to hear it and understand ithellip
Analysis
bull Quantitative (Meta-Analysis)
bull Average effect of feedback is 041bull Average of 041 standard deviation of improvement 50th to 66th percentile
bull 38 percent of studies sampled had a negative effect on learning (better learning without feedback)
Kluger amp DeNisi 1996
bull Effective feedback is what we need
Competitive ClappingFeedback
Steve Capey
Clapping Contest
bull Imagine you are taking part in a clapping contest
bull Itrsquos an odd thing to do but just imagine it
bull Three judges are chosen to rate the quality of clapping on a 1-5 scale with 5 being the very best score and 1 being the worst
bull You are competing in this contest and you really want to do well
bull You have one practice trial where you get feedback from each judge and then you do it for real
httpwwwwikihowcomClap-Your-Hands
Do the basic clap
Open your hands and clap your
palms against each other with the
fingers held up towards the sky Do
it hard enough to get a good loud
smacking sound out of it but not so
hard you turn your hand red Some
people clap more by clapping the
fingers of one hand against the
palm of the other Do whatever
feels most comfortable for you
Stop clapping when it starts
to taper off
As soon as the clapping starts
to die down itrsquos ok to stop
clapping Clapping isnrsquot a
chance to interrupt a
performance itrsquos a chance to
celebrate it Get quiet with the
crowd and dont act silly
Do the royalty clap
You know when the Queen
comes out of the castle and
decides to applaud her loyal
subjects with a brief applause
Thats what youre going for A
demure clap can be done just by
clapping with the first two fingers
tapping them into your palm
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Importance of Feedback
ldquoClinical teachers should regard the art of giving feedback as a critical skill to be acquired through repeated practice and augmented by reflection on their own performancerdquo
(Cantillon amp Sargeant 2008)
Why is Feedback Important
bull Good performance is not reinforced and poor performance remains uncorrected
bull If a teacher makes no comment trainees may assume that all is well
bull Learners may have to rely on unreliable hearsay from colleagues and administrators to get the feedback they so desperately need
bull Learners may have to guess their level of competence based on how well they are coping
bull Learners may have to learn by trial and error at patientsrsquo expense
Power of Feedback
bull Formative Feedbackbull The power comes from the double approach of addressing both cognitive and
motivational domains bull Cognitive Gives information that allows them to understand where they are in their
learning and what to do next
bull Motivational Allows students to develop a feeling of control over their own learning
bull Good feedback contains information that the student can use however they must be able to hear it and understand ithellip
Analysis
bull Quantitative (Meta-Analysis)
bull Average effect of feedback is 041bull Average of 041 standard deviation of improvement 50th to 66th percentile
bull 38 percent of studies sampled had a negative effect on learning (better learning without feedback)
Kluger amp DeNisi 1996
bull Effective feedback is what we need
Competitive ClappingFeedback
Steve Capey
Clapping Contest
bull Imagine you are taking part in a clapping contest
bull Itrsquos an odd thing to do but just imagine it
bull Three judges are chosen to rate the quality of clapping on a 1-5 scale with 5 being the very best score and 1 being the worst
bull You are competing in this contest and you really want to do well
bull You have one practice trial where you get feedback from each judge and then you do it for real
httpwwwwikihowcomClap-Your-Hands
Do the basic clap
Open your hands and clap your
palms against each other with the
fingers held up towards the sky Do
it hard enough to get a good loud
smacking sound out of it but not so
hard you turn your hand red Some
people clap more by clapping the
fingers of one hand against the
palm of the other Do whatever
feels most comfortable for you
Stop clapping when it starts
to taper off
As soon as the clapping starts
to die down itrsquos ok to stop
clapping Clapping isnrsquot a
chance to interrupt a
performance itrsquos a chance to
celebrate it Get quiet with the
crowd and dont act silly
Do the royalty clap
You know when the Queen
comes out of the castle and
decides to applaud her loyal
subjects with a brief applause
Thats what youre going for A
demure clap can be done just by
clapping with the first two fingers
tapping them into your palm
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Why is Feedback Important
bull Good performance is not reinforced and poor performance remains uncorrected
bull If a teacher makes no comment trainees may assume that all is well
bull Learners may have to rely on unreliable hearsay from colleagues and administrators to get the feedback they so desperately need
bull Learners may have to guess their level of competence based on how well they are coping
bull Learners may have to learn by trial and error at patientsrsquo expense
Power of Feedback
bull Formative Feedbackbull The power comes from the double approach of addressing both cognitive and
motivational domains bull Cognitive Gives information that allows them to understand where they are in their
learning and what to do next
bull Motivational Allows students to develop a feeling of control over their own learning
bull Good feedback contains information that the student can use however they must be able to hear it and understand ithellip
Analysis
bull Quantitative (Meta-Analysis)
bull Average effect of feedback is 041bull Average of 041 standard deviation of improvement 50th to 66th percentile
bull 38 percent of studies sampled had a negative effect on learning (better learning without feedback)
Kluger amp DeNisi 1996
bull Effective feedback is what we need
Competitive ClappingFeedback
Steve Capey
Clapping Contest
bull Imagine you are taking part in a clapping contest
bull Itrsquos an odd thing to do but just imagine it
bull Three judges are chosen to rate the quality of clapping on a 1-5 scale with 5 being the very best score and 1 being the worst
bull You are competing in this contest and you really want to do well
bull You have one practice trial where you get feedback from each judge and then you do it for real
httpwwwwikihowcomClap-Your-Hands
Do the basic clap
Open your hands and clap your
palms against each other with the
fingers held up towards the sky Do
it hard enough to get a good loud
smacking sound out of it but not so
hard you turn your hand red Some
people clap more by clapping the
fingers of one hand against the
palm of the other Do whatever
feels most comfortable for you
Stop clapping when it starts
to taper off
As soon as the clapping starts
to die down itrsquos ok to stop
clapping Clapping isnrsquot a
chance to interrupt a
performance itrsquos a chance to
celebrate it Get quiet with the
crowd and dont act silly
Do the royalty clap
You know when the Queen
comes out of the castle and
decides to applaud her loyal
subjects with a brief applause
Thats what youre going for A
demure clap can be done just by
clapping with the first two fingers
tapping them into your palm
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Power of Feedback
bull Formative Feedbackbull The power comes from the double approach of addressing both cognitive and
motivational domains bull Cognitive Gives information that allows them to understand where they are in their
learning and what to do next
bull Motivational Allows students to develop a feeling of control over their own learning
bull Good feedback contains information that the student can use however they must be able to hear it and understand ithellip
Analysis
bull Quantitative (Meta-Analysis)
bull Average effect of feedback is 041bull Average of 041 standard deviation of improvement 50th to 66th percentile
bull 38 percent of studies sampled had a negative effect on learning (better learning without feedback)
Kluger amp DeNisi 1996
bull Effective feedback is what we need
Competitive ClappingFeedback
Steve Capey
Clapping Contest
bull Imagine you are taking part in a clapping contest
bull Itrsquos an odd thing to do but just imagine it
bull Three judges are chosen to rate the quality of clapping on a 1-5 scale with 5 being the very best score and 1 being the worst
bull You are competing in this contest and you really want to do well
bull You have one practice trial where you get feedback from each judge and then you do it for real
httpwwwwikihowcomClap-Your-Hands
Do the basic clap
Open your hands and clap your
palms against each other with the
fingers held up towards the sky Do
it hard enough to get a good loud
smacking sound out of it but not so
hard you turn your hand red Some
people clap more by clapping the
fingers of one hand against the
palm of the other Do whatever
feels most comfortable for you
Stop clapping when it starts
to taper off
As soon as the clapping starts
to die down itrsquos ok to stop
clapping Clapping isnrsquot a
chance to interrupt a
performance itrsquos a chance to
celebrate it Get quiet with the
crowd and dont act silly
Do the royalty clap
You know when the Queen
comes out of the castle and
decides to applaud her loyal
subjects with a brief applause
Thats what youre going for A
demure clap can be done just by
clapping with the first two fingers
tapping them into your palm
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Analysis
bull Quantitative (Meta-Analysis)
bull Average effect of feedback is 041bull Average of 041 standard deviation of improvement 50th to 66th percentile
bull 38 percent of studies sampled had a negative effect on learning (better learning without feedback)
Kluger amp DeNisi 1996
bull Effective feedback is what we need
Competitive ClappingFeedback
Steve Capey
Clapping Contest
bull Imagine you are taking part in a clapping contest
bull Itrsquos an odd thing to do but just imagine it
bull Three judges are chosen to rate the quality of clapping on a 1-5 scale with 5 being the very best score and 1 being the worst
bull You are competing in this contest and you really want to do well
bull You have one practice trial where you get feedback from each judge and then you do it for real
httpwwwwikihowcomClap-Your-Hands
Do the basic clap
Open your hands and clap your
palms against each other with the
fingers held up towards the sky Do
it hard enough to get a good loud
smacking sound out of it but not so
hard you turn your hand red Some
people clap more by clapping the
fingers of one hand against the
palm of the other Do whatever
feels most comfortable for you
Stop clapping when it starts
to taper off
As soon as the clapping starts
to die down itrsquos ok to stop
clapping Clapping isnrsquot a
chance to interrupt a
performance itrsquos a chance to
celebrate it Get quiet with the
crowd and dont act silly
Do the royalty clap
You know when the Queen
comes out of the castle and
decides to applaud her loyal
subjects with a brief applause
Thats what youre going for A
demure clap can be done just by
clapping with the first two fingers
tapping them into your palm
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Competitive ClappingFeedback
Steve Capey
Clapping Contest
bull Imagine you are taking part in a clapping contest
bull Itrsquos an odd thing to do but just imagine it
bull Three judges are chosen to rate the quality of clapping on a 1-5 scale with 5 being the very best score and 1 being the worst
bull You are competing in this contest and you really want to do well
bull You have one practice trial where you get feedback from each judge and then you do it for real
httpwwwwikihowcomClap-Your-Hands
Do the basic clap
Open your hands and clap your
palms against each other with the
fingers held up towards the sky Do
it hard enough to get a good loud
smacking sound out of it but not so
hard you turn your hand red Some
people clap more by clapping the
fingers of one hand against the
palm of the other Do whatever
feels most comfortable for you
Stop clapping when it starts
to taper off
As soon as the clapping starts
to die down itrsquos ok to stop
clapping Clapping isnrsquot a
chance to interrupt a
performance itrsquos a chance to
celebrate it Get quiet with the
crowd and dont act silly
Do the royalty clap
You know when the Queen
comes out of the castle and
decides to applaud her loyal
subjects with a brief applause
Thats what youre going for A
demure clap can be done just by
clapping with the first two fingers
tapping them into your palm
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Clapping Contest
bull Imagine you are taking part in a clapping contest
bull Itrsquos an odd thing to do but just imagine it
bull Three judges are chosen to rate the quality of clapping on a 1-5 scale with 5 being the very best score and 1 being the worst
bull You are competing in this contest and you really want to do well
bull You have one practice trial where you get feedback from each judge and then you do it for real
httpwwwwikihowcomClap-Your-Hands
Do the basic clap
Open your hands and clap your
palms against each other with the
fingers held up towards the sky Do
it hard enough to get a good loud
smacking sound out of it but not so
hard you turn your hand red Some
people clap more by clapping the
fingers of one hand against the
palm of the other Do whatever
feels most comfortable for you
Stop clapping when it starts
to taper off
As soon as the clapping starts
to die down itrsquos ok to stop
clapping Clapping isnrsquot a
chance to interrupt a
performance itrsquos a chance to
celebrate it Get quiet with the
crowd and dont act silly
Do the royalty clap
You know when the Queen
comes out of the castle and
decides to applaud her loyal
subjects with a brief applause
Thats what youre going for A
demure clap can be done just by
clapping with the first two fingers
tapping them into your palm
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
httpwwwwikihowcomClap-Your-Hands
Do the basic clap
Open your hands and clap your
palms against each other with the
fingers held up towards the sky Do
it hard enough to get a good loud
smacking sound out of it but not so
hard you turn your hand red Some
people clap more by clapping the
fingers of one hand against the
palm of the other Do whatever
feels most comfortable for you
Stop clapping when it starts
to taper off
As soon as the clapping starts
to die down itrsquos ok to stop
clapping Clapping isnrsquot a
chance to interrupt a
performance itrsquos a chance to
celebrate it Get quiet with the
crowd and dont act silly
Do the royalty clap
You know when the Queen
comes out of the castle and
decides to applaud her loyal
subjects with a brief applause
Thats what youre going for A
demure clap can be done just by
clapping with the first two fingers
tapping them into your palm
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
What did you think about the judges feedback
Which judge gave the most effective feedback
Why
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Judge 1
yoursquove gotten feedback ndash your marks ndash but you have no idea what theyrsquore based on You know you need to change something But what Theyrsquove given you no clue so yoursquore equally likely to change for the worse as change for the better
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Judge 2
Yoursquove been told what not to do but you donrsquot know what your goal is So you can avoid the behavior you know they didnrsquot like (being quiet starting too loudly and not having enough texture and clapping too fast) But what are they looking for There are many many ways of clapping that avoid those things but still arenrsquot right Note too that in my example I had the judges give negative feedback But it works the same way if they only praised you If they tell you what you did right but gave you mediocre marks you know you need to change But you donrsquot know what or how
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Judge 3
This is the most useful They tell you what your goal is ndash eliminating a whole range of possible behaviors They tell you which aspects of your technique will help you towards optimal performance They tell you what they donrsquot like as well And they even give you some ideas for techniques you may not have thought about
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback questions
bull Effective feedback should allow the learner to be able to answer these questions bull Where am I going
bull What level of performance is expected (Reference)
bull How am I goingbull At what level is the student performing now (Actual)
bull Where nextbull Plan of action to close the gap (if one exists)
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Learner Dissatisfaction With Feedback
bull Too brief
bull Too negative
bull Too difficult to decipher
bull Too difficult to understand
bull Does not provide guidance on how to do things differently
Gibbs (2003)
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
What is lsquoeffectiversquo feedback
bull Marks vs Commentsbull Learners will look at feedback in this order
1 PassFail
2 Grade
3 Commentsbull What was weak
bull What was strong
bull Depending on timing and quality of feedback
bull Agreement of student view of feedback often depends on alignment with own view
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback Timing
bull Important for students to receive feedback whilst still focused on the task and when there is still time to do something about it
Good Timing Poor Timing
Returning a test the next day Two weeks after test
Immediate oral response to misconceptions
Ignoring errors or misconceptions
Going over things when module is over No opportunity to improve performance
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Quality of Feedback
Ineffective feedback High quality feedback
Vague not descriptive may include sweeping generalisationsldquoYou did wellrdquo
Specific descriptiveldquoYou took time with the patients and explored their issues and expectations wellrdquo
Unnecessarily harshFocuses on negativeldquoYou canrsquot prioritise can yourdquo
Fair even-handed constructiveldquoPreparing an outline of your reading may help you consolidate conceptsrdquo
Focused on personality traitsldquoYou are too competitiverdquo
Focused on behaviourperformanceldquoyour views are valuable I also think that it is important to hear the views from the rest of the team toordquo
Based on rumour hearsayldquoI was told that you were poor at performing examinationsrdquo
Based on personal observationldquoI can see that you are having problems with your calculationsrdquo
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Model of Feedback
bull Feedback about the task
bull Feedback about processing the task
bull Feedback about self regulation
bull Feedback about the student as a person
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback Things to Consider
bull Timing When given amp how often
bull Amount How many points made length of point
bull Mode Oral Written VisualDemonstration
bull Audience Individual vs GroupClass
bull Focus On work process self-regulation personality
bull Comparison To criterion to norm to self
bull Function Descriptive and non-judgemental
bull Valence Positive or Negative
bull Clarity Clear to student (not self)
bull Specificity Not overly general or just small details
bull Tone What the student will hear
Brookheart
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
The responsibility of the Learner
bull Listen to it (rather than prepare your responsedefence)
bull Ask for it to be repeated if you did not hear it clearly
bull Assume it is constructive until proven otherwise then consider and use those elements that are constructive
bull Pause and think before responding
bull Ask for clarification and examples if statements are unclear or unsupported
bull Accept it positively (for consideration) rather than dismissively (for self-protection)
bull Ask for suggestions of ways you might modify or change your behavior
bull Respect and thank the person giving feedback
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Rules of Feedback
bull Base feedback on direct observationbull Describe what lsquoYoursquo saw It is difficult to base feedback on what someone else
reported and it lacks authenticity
bull Begin session with self assessmentbull Most students are more self critical than we would be based on their own
lsquonovicersquo understanding of performance
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback and Literature
bull Feedback has been demonstrated to reinforce or modify behaviourbull Positive feedback can reinforce good practices (Thorndike 1931)
bull Negative feedback can cause problems with motivation (Kluger amp DeNisi 1996)
bull Feedback enhances clinical performance (Veloski et al 2006)
bull If done well feedback is a very effective tool to assist learning
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Barriers to Feedback (Krackov 2009)
Time and Placebull Shortage of time no place to give feedback
Knowledge basebull Unclear about purpose of feedback lack of performance data
Abilitybull No training in giving or receiving feedback
Affective factorsbull Poor rapport worries about the effect of negative feedback
Different expectationsbull Different perceptions between learner and teacher
Culture bull A culture that values feedback as a two way dialogue is essential
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Types of Feedback
bull Ongoing feedback (informal)bull Frequent
bull Immediate often unplannedspontaneous
bull Mid-course feedback (Formal)bull Scheduled in advance planned
bull Teachers observations over time
bull End of course feedback (formal)
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Three Methods For Feedback
bull Multiple methods exist for providing feedback
bull No right way for everyone and every situation
bull Mixtures of the elements of the methods can help to develop a rich feedback session
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
The Feedback Sandwich
bull Providing reinforcing and corrective feedback together
ldquoKiss Kick Kissrdquo
bull Sandwich corrective feedback between reinforcing feedback
bull Power balance favours the teacher
bull Passive for the learner
bull Try to avoid reinforcing the corrective statements by cuing it with words like ldquoButrdquo or ldquohoweverrdquo
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
The Feedback Sandwich
bull Reinforcing ldquoI like the way that you systematically examined Mr Smithrsquos abdomen using the
flat of your handrdquo
bull CorrectiveldquoI noticed that you did not look at Mr Smithrsquos face as you palpated to check
whether you were causing him any discomfortrdquo
bull ReinforcingldquoYou finished by summarising your findings accurately and succinctly well
donerdquo
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Pendleton Model
bull A structured approach to establishing a conversation about performance
bull Evolution of the feedback sandwichbull Teachers comments are preceded by learners observations
bull Four step approach
bull Works best when in a one to one situation with the learner to discuss after the event
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Pendletonrsquos rules
bull Check the learner wants and is ready for feedback
bull Let the learner give commentsbackground to the material that is being assessed
1 The learner states what was done well
2 The observer(s) state what was done well
3 The learner states what could be improved
4 The observer(s) state how it could be improved
bull An action plan for improvement is made
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Reflective Feedback Conversation
bull Encourage learners to reflect on actionsbull Less structured than previous models
bull Similar to Calgary Cambridge communication skills model
bull Focuses on essential goals of feedbackbull Encourage learners to reflect on their actions and to motivate subsequent
improvement in performance
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Reflective Feedback
Teacher ldquoLetrsquos review the surgery Is there anything you have concerns about that perhaps didnrsquot go as well as you had hopedrdquo
Learner ldquoI wasnrsquot happy with tumour resection I found it very hard to prize it off the posterior wall of the bladder and it bled a lotrdquo
Teacher ldquoIt was clearly difficult for you to create a plane of cleavage between the tumour and the bladder wall I find this difficult toordquo
Teacher ldquoIs there anything you can think of that might work better make it easier or improve it for next timerdquo
Learner ldquoWell I was a bit anxious and perhaps because of that I was rushing and working too quicklyrdquo
Teacher ldquoYes thatrsquos a good point I would encourage you to slow down at times like these and that allows you to be even more delicate in your approach Another suggestion is to use a blunt dissection technique rather than a scissors dissection Does that make sense to yourdquo
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
FeedbackTask
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
The Matrix - Coin and Card Trick
bull Learn the trick and receive feedback
bull Watch the ldquoYou Tube video tutorialrdquo
bull httpwwwyoutubecomwatchv=dW-tnkmEdtcampfeature=channelamplist=UL
bull Select a method to provide feedback
bull Swap over with partner and try another feedback method
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback from the Task
bull What methods did you try
bull How did it feel giving feedback
bull How did it feel receiving feedback
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
References
bull Brookheart S (2008) How to give effective feedback to your students ASCD books
bull Ramaprasad A (1983) On the definition of feedback Behavioural Science 28 pp4-13 Houston Journal of the Society for General Systems Research
bull Veloski J Boex JR Grasberger MJ Evans A Wolfson DB 2006 Systematic review of the literature on assessment feedback and physicians clinical performance BEME Guide No 7 Med Teach Mar28(2)117-28
bull Kluger Avraham N DeNisi (1996) The effects of feedback interventions on performance A historical review a meta-analysis and a preliminary feedback intervention theory Angelo Psychological Bulletin Vol 119(2) 254-284
bull Cantillon P Sargeant J Giving feedback in clinical settings BMJ 2008 337a1961
bull Thorndike E L (1931) Human learning Century psychology series
bull Peter Cantillon Linda Hutchinson and Diana Wood ABC OF LEARNING AND TEACHING IN MEDICINE 2010 Wiley-Blackwell
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge One
bull Sigh and put your head in your hands during the clapping
bull Hold up the number two
bull Say nothing
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Two
bull Shake your head and say
ldquoToo quiet Much too quietrdquo
bull Pause
ldquoI donrsquot really like the fact that you started your applause at such a quick pace There was no texture to your performance and the beats were much too close togetherrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two
Feedback from judge Three
bull Smile and thank the contestant
ldquoWhat I think really makes an excellent performance is a performance that builds I like it to began slowly and then get louder and louder almost like a crashing waverdquo
ldquoWhat you did was great for the end part but it would have much more impact if you created some contrast between the beginning and the endrdquo
ldquoYou can also increase the crescendo by starting with slower quieter clapping but then getting faster and louder towards the real triumphant ending
Your clapping at the end was quite goodrdquo
ldquoYoursquore looking for a sharper sounds as well You keep clapping with the middle of your hands but you really want that sharp sound to give it some definition I absolutely hate that hollow palm on palm soundrdquo
bull You give a score of two
bull Hold up the number two