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Barriers to giving effective feedback

Hesketh and Laidlaw (2002) identify a number of barriers to giving effective feedback in the context of medical education:

  • a fear of upsetting the trainee or damaging the trainee–doctor relationship
  • a fear of doing more harm than good
  • the trainee being resistant or defensive when receiving criticism. Poor handling of a reaction to negative feedback can result in feedback being disregarded thereafter
  • feedback being too generalised and not related to specific facts or observations
  • feedback not giving guidance on how to rectify behaviour
  • inconsistent feedback from multiple sources
  • a lack of respect for the source of feedback.

Parsloe (1995) also identifies that feedback must be given sensitively and appropriately. He notes that it is easy for those giving feedback ‘to take the relationship aspect of their roles for granted… particularly if the (teacher) has been working with their learner for some time’ (p. 149). Learners are often in a dependent and subordinate role to teachers or trainers, and it is easy to dismiss issues of organisational power and authority that often underpin work relationships. This is particularly important if the organisational culture is bureaucratic, hierarchical or results oriented, and in healthcare, where there are often tensions around professional role boundaries and status. Where this influences feedback is in being clear about the expectations and aiming to develop a supportive, relaxed and informal environment. It is also about having respect for the person giving feedback.

Other aspects between the person giving feedback and the recipient include differences in sex, age or educational and cultural background. These are not necessarily obstacles, but they may make feedback sessions strained and demotivating.

Thinking point

  • Think about when you are given feedback – what do you think acts as a barrier? 

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