Intended for healthcare professionals

Views And Reviews

How do we make feedback meaningful?

BMJ 2020; 368 doi: (Published 07 January 2020) Cite this as: BMJ 2020;368:m17
  1. Kate Womersley, academic foundation year 2 doctor1,
  2. Katherine Ripullone, academic foundation year 2 doctor2
  1. 1Royal Infirmary of Edinburgh, UK
  2. 2Norfolk and Norwich University Hospital, UK
  1. v1kwomer{at}

Positive feedback motivates trainees, reinforces what’s going well, and encourages repetition. But has the volume become overwhelming?

As a junior doctor, there’s no escape from feedback.

Multiscore feedback at least once a year (twice in Scotland) from other doctors, nurses, ward staff, and medical students provides commentary on a junior’s competence, professional approach, and teamworking. One negative comment triggers a further round of feedback. Workplace based assessments to appraise clinical reasoning, practical skills, and patient interaction are signed off by senior clinicians. Educational supervisors then give feedback on this feedback, but only after trainees complete feedback about their own performance.

Juniors give even more feedback than they receive: for colleagues’ e-portfolios and appraisals, weekly teaching sessions, satisfaction ratings for conferences, the four monthly NHS training survey, and annual GMC survey. What might be constructive dialogue can stray into ransom. Receiving a continuing professional development certificate after an educational event is conditional on submitting feedback. The NHS’s untested …

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