Terrific T6 talks – Giving Feedback

In Education & Quality Improvement by Nadim Lalani1 Comment

“Waiter … I specifically asked for a SH#T sandwich!”

Most educators know how to give feedback using the “SH#T Sandwich Technique” [Good points followed by bad points followed by a “there’s still hope for the future” statement].

Here’s a great link by the Alberta Rural Physicians Action Plan that provides concise and high-quality teaching tools for clinicians including how to give effective feedback.[bookmark this site]

Feedback and the Learning cycle:

Learners exist in a cycle of competence. You need to know where they are in the cycle so that you can assist.

  1. unconsciously incompetent [make them aware]
  2. consciously incompetent  [find out why they seem to be making a poor choice]
  3. consciously competent [need support and encouragement]
  4. unconsciously competent [need a challenge]

Prime the learner for feedback before learning activity:

  1. Mutually set goals
  2. Tell them that you’re going to be collaborative
  3. Anticipate giving feedback
  4. Call it “feedback” or “coaching”

Provide feedback as follows:

  1. Encourage Student’s self-assessment
  2. Reinforce the good points in this self-assessment
  3. Ask about problem areas
  4. Correct mistakes by:
    1. encouraging reflection and self-correction
    2. suggesting modifications
    3. be specific
    4. Interjections during bedside teaching. NOTE: these need to be done in a non-threatening manner and really should only be reserved for more critical errors.
[note the refreshing absence of the SH#T sandwich]
Nadim is an emergency physician at the South Health Campus in Calgary, Alberta. He is passionate about online learning and recently made a transition into human performance coaching. He is currently working on introducing the coaching model into medical education.