Intended for healthcare professionals

Practice Essentials

Medical education: giving feedback to doctors in training

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4523 (Published 19 July 2019) Cite this as: BMJ 2019;366:l4523
  1. Emer Kelly, consultant respiratory physician; UCD associate clinical professor, University College Dublin1,
  2. Jeremy B Richards, assistant professor of medicine2
  1. 1St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland.
  2. 2Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to: E Kelly emer.kelly{at}svuh.ie

What you need to know

  • Being observed and receiving feedback prompts reflection and constructive modification of skills

  • Feedback is beneficial in learners of all performance levels, not just learners with significant deficits in knowledge and skills

  • Effective feedback is relevant, specific, and focused on objective behaviours

Providing effective feedback is an essential component of being a good teacher. When delivered well, feedback improves doctors’ and students’ skillsets and establishes lifelong learning (fig 1). A 2013 literature review described the characteristics of learners interested in feedback in terms of the self-motives framework (self assessment, self improvement, self enhancement, and self verification) and concluded that feedback‐seeking behaviour is valuable for individuals in work and educational settings as it aids their adaptation, learning, and performance.1

Fig 1

Clinical learning is an ongoing cycle of progress pivoting on feedback

While the literature about feedback is broad and characterised by a lack of high quality, evidence based guidance or internationally recognised guidelines, consensus opinion and reviews of available quantitative and qualitative results indicate that effective feedback is based on observations, given in a conducive environment, characterised by a non-judgmental approach, focused on specific skills and behaviours, and limited in quantity to avoid overwhelming learners.23

This article is written for clinicians who teach and outlines how to give effective feedback to students and doctors in training, and why it is important. We provide specific strategies and approaches for clinicians and clinician educators to assist in developing and providing effective feedback to medical learners.

What is feedback?

A useful working definition of feedback is “Information describing performance in a given activity that is intended to guide future performance in that same or related activity.”4. Feedback can be either formative or summative in nature.

Formative feedback is provided during or shortly after a specific encounter or experience, with the content focusing constructively on …

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