GIVING

EFFECTIVE
FEEDBACK
Syifa Mustika
OVERVIEW
Apa & Mengapa Feedback
Prinsip-prinsip Feedback Efektif
Berbagai Aplikasi Feedback dalam
Pembelajaran Klinis – Termasuk penerapan
refleksi
Praktik Feedback
APA & MENGAPA FEEDBACK
 Sudah baik …. tinggal
perlu pengulangan
Tanganmu le.... biar lebih luwes
tanganmu !

DOSEN BADAL
THE NATURE OF LEARNING BY KOLB
MODELS FOR CLINICAL TEACHING
FEEDBACK
(Reinforcement or correction) + Explanation
Keeps learner on course to meet goals
No judgment against external standards; no matter
where learner is in relation to external standards,
feedback is always helpful
If done well, the learner does not feel judged,
enhances capacity for reflection, and therefore
lifelong professional development
FEEDBACK
“informasi spesifik yang
“informasi spesifik yangdiberikan
diberikan kepada
kepada peserta
peserta didik
didik/peer terkaitakurasi,
terkait dengan dengan kebenaran
akurasi, kebenaran dan
dan kesesuaian
kesesuaian
performa yang performa
ditunjukkanyang ditunjukkan
terhadap terhadap
teori/standar yang
teori/standar
diharapkan yang
untukdiharapkan untuk kepentingan
kepentingan perbaikan
perbaikan (improvement)”.
(improvement)”. 1
1
 RATIONALE FOR GIVING FEEDBACK
Without feedback, mistakes go uncorrected, good
performance is not reinforced, and clinical
competence is achieved empirically or, not at all.
Good feedback promotes the skill of reflection,
which is essential for the development of expertise
and lifelong learning.

Ende J. Feedback in Clinical Medical Education. JAMA 1983;250:777-781.

Bing-You RG, Trowbridge RL. Why medical educators may be failing at feedback. JAMA 2009;302:1330-1331.
THE PRINCIPLES OF
EFFECTIVE FEEDBACK
ENDE PRINCIPLES OF GOOD FEEDBACK
Aligns the goals of teacher and learner
Is well-timed and expected
Is based on first hand observation
Is regulated in quantity and limited to remediable behavior
Is phrased in descriptive, non-evaluative language
Deals with specific performance
Deals with decisions and actions rather than assumed
intentions or interpretations
Ende J. Feedback in Clinical Medical Education. JAMA 1983;250:777-781.
WHAT ARE THE BIGGEST CHALLENGES
TO GIVING GOOD FEEDBACK?
BARRIERS….
It is uncomfortable
No one ever gave me feedback
Not quite sure how to do it
I hated getting feedback
Learner will not be receptive
Avoid confrontation
Not sure that the observed behavior is really a problem
Need to see it twice
MORE BARRIERS…

I’m not sure of the goals or the expected

behavior
It’s not my job
It’s not that important
There’s not enough time
 WHY ARE EDUCATORS FAILING AT FEEDBACK?
1) Not learner-centered/without awareness of the learner’s
perspective or self-assessment
2) Overpowering of affective reactions to feedback / a
failure to separate the behavior and the person (for teacher
and/or learner)
3) Unsuccessful feedback teaches learner to fear or avoid
feedback in the future
Bing-You RG, Trowbridge RL. Why medical educators may be failing at feedback. JAMA 2009;302:1330-
1331.
HOW CAN WE GIVE FEEDBACK
DOMAINS OF FEEDBACK

Knowledge
Skills
Attitude  Professionalism
GENERIC STEPS
1. Persiapan (the set up)
2. Memberikan feedback (Delivery)
3. Menyusun rencana tindak lanjut (The action
Plan)
4. Summarize, Closing & Reflection
BEFORE GIVING FEEDBACK:
PREPARE EFFECTIVELY
Set a time – major feedback should not take student by
surprise
Communicate goals and objectives for feedback -
Agree with students what will be discussed / learned
Plan what you will say
Make sure that you have enough information
Establish a respectful learning environment.
CORE FEEDBACK DELIVERY
Begin with student’s self assessment
Give both positive and constructive feedback
Provide specific, objective, observable, and
modifiable behaviors, not personality traits
Use non-judgmental/neutral language
Limit constructive feedback to two to four areas
AFTER GIVING FEEDBACK:
REFLECT ON HOW IT WENT
What was effective?
What could be done differently?
Were you well prepared?

Future strategies
Do you need to document?
Do you need help?
LIMIT THE QUANTITY
VARIOUS FEEDBACK APPLICATION
Teaching Methods Assessment Methods
- PBL  OSCE
- Sandwich  WPBA (Mini CeX, DOPS,
CbD, Viva OSLER, Mini PAT, P-
- OMP Mex)
- SNAPPS
- RIME
ONE MINUTE PRECEPTORSHIP (OMP) MODEL
1. Get a commitment - sets the learning environment; engages the
learner
2. Probe for supporting evidence - assesses the learner’s level of
knowledge and thinking process
3. Teach a general principle - organizes knowledge and
generalizes to future situations
4. Reinforce what was done well - reinforces good behaviors
5. Give guidance about errors or omissions - corrects
mistakes; forms foundation for improvement
OMP
Can be used in
- Ambulatory setting
- Ward
- Operation Teathre
For:
- Teaching Clinical Reasoning / Diagnosis
- Data intrepetation
- Decision Making / Treatment Planning
- Patient MAnagement
SEVEN DEADLY SINS TO AVOID
1. After a lesson just ask, “Do you understand?”
2. Not giving feedback to students.
3. Tell students to change their personality traits rather than their
behavior.
4. Not tell students what you want them to learn.
5. Do all the talking; make the students do all the listening.
6. Be too busy to teach students.
7. Be boring when you teach.
END WITH ENDE
“The important things to remember about
feedback in medical education are that (1) it is
necessary, (2) it is valuable, and (3) after a bit of
practice and planning, it is not as difficult as one
might think.”

--Jack Ende, MD
Ende J. Feedback in Clinical Medical Education. JAMA 1983;250:777-781.
THANK YOU

LOGO
DISCUSSION
“SLEEPING” VIDEO: PART 1
Take notes on what you observe:
What did the residents think of the student?
What feedback was delivered?
How did the student respond?

Discuss with your partner

VIDEO
“SLEEPING” VIDEO: PART 2
Here are the same residents after additional
training
What was done differently?
Do you detect a different structure to the
feedback?
How did the student respond?

Discuss with your partner

VIDEO
WHAT MORE COULD THE RESIDENT HAVE DONE?
Make explicit what was learned:
PROFESSIONALISM
More advanced
Expected
Self directed: takes
Responsible and reliable responsibility for learning and
Industrious and dedicated behavior
Enthusiastic and motivated Actions based on accurate
understanding of perspectives
Appropriately respectful and needs of others: including
and empathic patients, team
Honest and trustworthy Overcomes performance
preoccupation to focus on
patients and learning
ACKNOWLEDGEMENTS
Funding:
Lyuba Konopasek, MD Glenda Garvey Teaching
Academy, Columbia University
Andrew Mutnick, MD
John Encandela, PhD
Gingi Pica, MPH Actors:
Maya Castillo
Center for New Media and Thomas Hooven
Technology: Benjamin Kennedy
Michelle Hall, BS Daniel Vo