Timing can also present obstacles. “Many competing demands for our attention exist; it’s easy to complete an encounter or case and then immediately move on to the next task,” Dr. Bowe said. “But giving feedback verbally doesn’t have to take a lot of time, especially if a specific defined goal is articulated before the engagement. Another option is to consider using feedback platforms, such as myTIPreport, to capture information in real-time and make it available for a later conversation.”
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January 2025While Sarah K. Rapoport, MD, assistant professor in the department of otolaryngology–head and neck surgery at Georgetown University Hospital and the Washington, D.C. Veterans Affairs Medical Center in Washington, D.C., tries to provide feedback in the moment, she also tries to gauge when that might be less effective. In those situations, she lets time pass so that heightened emotions can subside before addressing the issue and providing feedback. “My goal in these cases is to try to improve a learner’s ability to hear and internalize feedback so they can optimally receive it, internalize its value, and then apply it moving forward,” she said.
Along these lines, Dr. deSilva said that sometimes a trainee may seem to shut down or not enjoy receiving feedback. In those situations, it can be best to circle back several days later—after they’ve had time to process everything.
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For some clinicians, “doing the deed” can cause anxiety. “If you approach the conversation in a way that it will be an uncomfortable situation, then it will make it a less easy conversation to have,” Dr. Jamal said.
If you only give feedback when something bad happens, then residents will dread a feedback session — Nausheen Jamal, MD, MBA
Dr. Jamal begins a conversation about critical or constructive feedback in a similar way to discussing complex information with a patient. “I want to make sure I understand where the patient is coming from and what their understanding of their condition is, and then base my explanation on what they already know and understand,” she said. For residents, she will ask how they thought they did when performing a particular surgery, what they think they’ve mastered, and what steps they still find challenging.
Determine what you want to say and say it clearly; don’t beat around the bush, Dr. Jamal continued. To quote the title of an article by American academic Brené Brown, “Clear is kind. Unclear is unkind.”
Upon reflection, Dr. Chen said that most of her poor experiences giving feedback stemmed from not having built a good foundational relationship with a learner before providing feedback that’s difficult to hear. “Without a foundation of trust and respect, feedback can strain a relationship,” she said.
Knowing a resident’s thought process behind their decisions during a case can help me provide specific feedback, particularly when I was expecting a different thought process. — Sarah K. Rapoport, MD