Feedback is a vital part of education and training. When the process of providing feedback is carried out well, the feedback can motivate learners and help them to improve their performance. Constructive feedback is information-specific, issue-focused, and based on observations. Constructive feedback will identify strengths (what the student has done well) and areas for improvement (where the student might have done better). The process of providing learners with constructive feedback should be part of the overall interaction between teacher and learner, should include student's self assessment and not be a one-way communication from teacher to learner.

Price (see taking it further) suggests that feedback can serve a number of purposes

1. Correction (helping students to put things right by taking corrective action);
2. Reinforcement (a stimulus providing positive or negative reinforcement to behavior);
3. Forensic Diagnosis (diagnosing problems with the work so that students can see how to improve);
4. Benchmarking (identifying a gap between current performance and the standard of expected performance); an
5. Longitudinal development (supporting improvements in the next assignment and beyond).

 

It is important that both staff and students are clear about a) the purpose(s) of feedback and b) the value of feedback. Lack of understanding of purpose can lead to feedback that is confused, confusing and ultimately ineffective for both parties. Lack of understanding of the value of feedback can result in teachers failing to meet students' developmental needs and in students failing to see the utility of feedback for their short term and long term development. Ultimately teaching staff want to see students apply feedback in subsequent work and students want to see applicability of feedback in the "content and timing of feedback provided." The surest way to achieve this is to have a developed relationship between teachers and students.

Feedback in academic and clinical settings can be informal, in day-to-day encounters between teachers and students or it can be more formal as part of written or clinical assessment of learners' performance (See Hesketh in Taking it Further). Feedback can also take a variety of forms and come from a number of sources. For example, feedback can be written, verbal or numerical and depending on context it can come from academics, clinical educators, health professionals and from patients (e.g. communication and attitude). 

Whether formal or informal, feedback can have either a directive function or a facilitative function (See Archer in Taking it Further).

• Directive feedback tells the learner what needs to be corrected. For example, a clinical educator might notice that a student has omitted a step in the procedure for e.g. male catheter insertion whilst practicing on simulated patient. Directive feedback would simply point out the mistake and tell the student how to remedy the mistake.

• Facilitative feedback involves providing comments and suggestions to support recipients in self-correction. For example, a teacher might notice a student making a mistake whilst practicing e.g. male catheter insertion on a simulated patient. Facilitative feedback might consist of asking the student to review the steps in the procedure as opposed to telling the student what has been omitted.

Archer (see Taking it Further) suggests that facilitative feedback may work better for high achievers than for novice learners and that delayed feedback (wait until the task is completed) may be more appropriate for high acheivers engaged in complex tasks. These considerations do not provide the definitive answer on how to give feedback. However, they do indicate the need to consider how and when feedback is being given.

The previous section made it clear that providing good feedback is, to some degree, dependent on context and the students' ability. That is, the form and timing of the feedback depend on the achievement level of students, on what students are learning and on where students are learning. This makes it difficult to provide generic advice on providing good feedback. However, the following "rules" will broadly apply in a more formal feedback session.

To be effective, formal feedback should:

• Be given as soon after an evaluation/assessment as possible;
• Focus on the positive as well as areas for development;
• Highlight specific examples of where behaviours might be changed or where learning needs to occur;
• Suggest alternative behaviours or aspects for improvement (goal setting);
• Check for understanding of the feedback provided;
• Be given in an appropriate time and place;
• Be given privately;

Feedback should not:

• Be too general (telling a student that they did a great job on an essay may make the student feel good, but it does not help the student to understand their strengths);
• Criticise without making either directive or facilitative recommendations for change (students must supported in improving through e.g. goal setting);
• Be dishonestly kind (trying to spare a student's feelings ultimately does them a disservice).

The following guidelines apply broadly to giving informal feedback (See Hesketh in Taking it Further):

• Feedback should take place at the time of the even or very soon after so that the event is fresh in the mind of the student and educator;
• Feedback should focus on specific actions and not generalisations e.g. "You did X really well" rather than "Good job."
• Avoid body language and facial expressions that might convey unintended messages to the recipient e.g. rolling of the eyes, shaking of the head;
• Be careful when giving negative feedback in front of peers;
• Limit your feedback to what the trainee needs to know in order to improve.

Roger Booth talks about using technology to ensure students in a large class get timely feedback:

Click to view the video (requires Flash Player).

Clinical education settings are diverse and include small group settings, practical skills training and bedside teaching situations. A number of guidelines already discussed will apply to providing feedback in a clinical setting. For example, feedback needs to be delivered at an appropriate time and place and feedback needs to be constructive.

Wayne Hazel talks about ways to provide effective feedback in a clinical setting: 

Click to play the video.

Michelle Honey talks about giving a student appropriate feedback in the workplace:

Click to play the video.

Those involved in medical education might consider the fact that medical students and professionals tend to be high achievers and that medicine centers on personal clinical interactions. Particular models recommend themselves for oral feedback in this setting. For example, a model for two-way interaction between educator and learner that provides constructive goal oriented criticism may help to overcome perceived shortcomings in feedback provided in medical education settings (See Archer in Taking it Further). 

Archer, J. C. (2010). State of the Science in Health Professional Education: Effective Feedback. Medical Education, 44, 101-108.

Effective feedback may be defined as feedback in which information about previous performance is used to promote positive and desirable development. This can be challenging as educators must acknowledge the psychosocial needs of the recipient while ensuring that feedback is both honest and accurate. Current feedback models remain reductionist in their approach. They are embedded in the hierarchical, diagnostic endeavours of the health professions. Even when it acknowledges the importance of two-way interactions, feedback often remains an educator-driven, one-way process. Based on a review of the literature, this article suggests a new model for providing effective feedback.

 

Hattie, J. (2009). The Black Box of Tertiary Assessment. In L. H. Meyer, S. Davidson, H. Anderson, R. Fletcher, P. M. Johnston & M. Rees (Eds.), Tertiary Assessment & Higher Education Student Outcomes: Policy, Practice & Research (pp. 79-90). Wellington: Ako Aotearoa.

There has been a formative assessment revolution that has swept our compulsory schooling, and is about to descend on higher education. It has the potential to make major changes as to how assessment is undertaken, with more emphasis on “feedback from assessment” or “assessment for learning” (alongside the traditional “assessment of learning”), using assessment to improve and change what and how we teach. Students familiar with the power of this assessment model in high school (especially since the introduction of NCEA) will expect and demand different forms of feedback from assessment from their lecturers.

 

Hesketh‌, E. A., & Laidlaw‌, J. M. (2002). Developing the Teaching Instinct, 1: Feedback. Medical Teacher, 24(3), 245-248.

This is a very brief article on providing effective formal and informal feedback. It's useful if you want a high level overview of some of the challenges and ways of meeting those challenges.

Price, M., Handley, K., Millar, J., & O'Donovan, B. (2010). Feedback : All That Effort, But What Is the Effect? Assessment & Evaluation in Higher Education, 35(3), 277 - 289.

Drawing on findings from a three-year study focused on student engagement with feedback, this paper reveals the limited extent to which effectiveness can be accurately measured and challenges many of the assumptions and beliefs about effectiveness of feedback practices. Difficulties relating to multiple purposes of feedback, its temporal nature and the capabilities of evaluators reveal that measuring effectiveness is fraught with difficulty. The paper argues that the learner is in the best position to judge the effectiveness of feedback, but may not always recognise the benefits it provides. Therefore, the pedagogic literacy of students is key to evaluation of feedback and feedback processes.

Vickery, A. W., & Lake, F. R. (2005). Teaching on the Run Tips 10: Giving Feedback. Medical Journal of Australia, 183(5), 267-268.

This brief article provides practice tips for giving feedback in a clinical setting. Useful if you want a quick "how to" guide.

How To Give Feedback, The London Deanery

This module offers some suggestions on how you can improve the feedback you give so that you are better able to help motivate and develop learners’ knowledge, skills and behaviours.

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How do I make sure my feedback is timely and appropriate?

“A teaching philosophy can help you to reflect on how and why you teach. If you don’t have a teaching philosophy, you might want to consider writing one. You can take a look at What makes a good teacher? to get started. If you already have a teaching philosophy, you might want to reflect on how the work that you are doing here fits with that philosophy”.