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Giving informal feedback

Many opportunities exist for giving informal feedback to learners on a day-to-day basis. Such techniques often involve giving feedback to learners on their performance or understanding, with feedback being built into everyday practice and conversation. Those giving feedback can help the learner to move through the stages in the ‘competency model’ of supervision (Proctor, 2001; Hill, 2007) as shown in the table below.

  

Unconscious
incompetence

Conscious
incompetence

Conscious
competence

Unconscious
competence

Learner

Low level of competence. Unaware of failings

Low level of competence. Aware of failings but not having full skills to correct them

Demonstrates competence but skills not fully internalised  or integrated. Has to think about activities

Carries out tasks with conscious thought. Skills internalised and routine.
Little or no conscious awareness of detailed processes involved in activities  

Feedback 
giver

Helps learner to recognise weaknesses, identify areas for development and become conscious of incompetence

Helps learner to develop and refine skills, reinforces good practice and competence, demonstrates skills

Helps learner to develop and refine skills, reinforces good practice and competence through positive regular feedback

Raises awareness of detail and unpacks processes for more advanced learning, notes any areas of weakness/bad habits 

 

Providing informal on-the-job feedback can take only a few minutes of the teacher’s time. It might be fairly instructional and ‘in the moment’ (‘well done’, ‘a bit to the left’, ‘think about what we talked about with Mr Y’). To be the most effective, feedback should take place at the time of the activity or as soon as possible after so that the learner (and teacher) can remember the events accurately. The feedback should be positive and task-specific, focusing on the learners’ strengths and helping to reinforce desirable behaviours: ‘You made sure that you kept Mrs X fully informed during the procedure, I feel this helped to reassure her…’.  

Archer’s (2010) review however identifies that high-achieving learners undertaking complex tasks might benefit from delayed feedback rather than immediate feedback on steps in a sequence, which can inhibit performance and learning.


Negative feedback should also be specific and non-judgemental, possibly offering a suggestion: ‘Have you thought of approaching the patient in such a way…?’. Focus on some of the positive aspects before the areas for improvement: ‘You picked up most of the key points in the history, including X and Y, but I noticed you did not ask about Z…’. Unless a learner is putting someone at risk, avoid giving negative feedback in front of other people, especially patients. 

Keep the dialogue moving with open-ended questions: ‘How do you think that went?’, which can be followed up with more probing questions. Hesketh and Laidlaw (2003) also suggest that learners should be encouraged to ‘seek feedback themselves from others… feedback actually works best when it is sought’, reflecting the principle of encouraging self-directed assessment-seeking. You may need to support some learners in doing this more than others and direct them towards people who will be supportive at first to help build up their confidence and competence.

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