0:07
Welcome back.
I hope you've spent some time reflecting on why you think that feedback
is important.
Let me tell you about some of the reasons why I think it is important.
The first thing is, that it clarifies goals.
Learners may think that they know what is expected of them, but
in fact they often don't.
They have a sense of what they want to do, but they don't have a sense of what you
think that they ought to do, or perhaps what is the right thing to do.
So the, the clarifying goals through the provision of feedback will
help them identify what they need to be doing, and what they know is required.
Next thing is it, it emphasizes good performance.
If residents don't know, or learners don't know what is good, or
what is right, then they won't necessarily know what is the right thing to do.
And so by providing feedback, we're emphasizing the good performance.
This next thing is that it corrects mistakes.
If they're making a mistake, or not recognizing they're making a mistake, or
need help.
Trying to fix the mistake,
the feedback will help provide that information for them.
Next thing is it, for, it serves as a reference point, both for
summative, meaning the final grading or scoring,
as well as formative performance, meaning the, it, for performance for improvement.
So, it gives a learner a sense of where they're doing and
how they're doing, so that they know how they can improve for
the next time, or how they're doing in terms of a grade or a score.
All right, let's take a minute and talk about self-assessment.
You can see here that the little dog thinks that she's a great, big wolf, but
in fact she is not.
That is what we know about self-assessment,
is that people do not have a good sense of who they are, or what they look like, or
what they do, and that our own self assessment tends to be relatively poor.
In fact, 95% of college professors think that they are above average.
And as like Wobegon says, all of us are above average.
Now the issue is that we're not, right?
We all have areas in which we perform poorly, and
we all have areas in which we perform well.
So the important thing is that, feedback is to provide a better sense of
how we are actually doing as opposed to how we think that we are doing.
2:03
All right, let's talk about self assessment.
So, there's a great study by Kruger and
Dunning, that looked at three domains of performance.
The first one is grammar, the next was humor, and
the next one was math or arithmetic.
What they did is they took college students, in psych classes, and
they asked them to do exams or performance.
So they asked them to do tests of grammar, another set was tests of humor.
Another test was set, was tests of math.
They then categorized each of the groups into high performance and
low performance by quartiles.
So the top performance for the ones who did well, and
the bottom performance was the bottom quartile of those who did poorly.
What they then did is they asked each of the groups
to self assess on how they had done in the domain of performance.
2:45
And what they found was, that the high performers thought that they had
done more poorly then they actually did.
So the high performers thought that they were not as good as they actually were.
Where as the low performers all thought that they were above average.
So, despite the fact that the low performers preformed at the bottom
quartile, they thought that they were above average on their self assessment.
The next step is the series of studies was that they
then showed them what good performance looked like.
And they asked them to, determine what their own performance was.
The high performers were able to look at the good performance and
say, wow, I think I actually did okay, and
in fact, I think I was better than I was, than I initially thought that I was.
Where as the low performers did not do that.
They looked at good performance and
they were not able to judge that they had been a poor performer.
And in fact still thought that they were above average.
What's concerning about this,
is that we don't really know which category we fit into.
We don't know whether or not, when we think we're above average, whether or
not we're a high-performer, who's actually under-assessing their performance, or
a low-performer who is way over-assessing their performance.
And the only way to actually provide this information is by providing feedback,
rather than the self-assessment that is provided.
So let's step back and
go, and think about why feedback is important with this concept in mind.
4:05
So, the purpose of feedback is to provide and inform self-assessment.
Remember our little wolf here who thinks that she's a great big wolf, but
in fact she's just a little dog.
The feedback that we provide this learner,
is to help them understand who they really are, what their real capability is.
The next thing is to reinforce good behavior.
By providing feedback and giving a more accurate self assessment or
helping them form a more accurate self assessment,
it will reinforce good behavior on the part of the learner.
The next thing is, that learners think that they're doing something,
this is the self-assessment piece.
They think that they are doing a good job, doing the right thing.
But, in fact, their performance is quite poor.
And so, the feedback is to provide information about that actual performance.
This child is a nose picker, she may think that nose picking is just fine.
But, if you provide her information about that, and
let her know that this is not acceptable performance, it will help her.
And form her own opinions and her own behavior so that she can improve.
The other piece about feedback is that it should hopefully help reduce
anxiety or insecurity.
If we don't have a sense of how we're doing and we're always concerned about am
I okay, am I not okay, particularly if one tends to be an anxious learner.
By providing feedback, we're assuring them of what they're doing well and
providing guidance about what they think they should be doing better.
The next thing about Feedback is that it really provides a commitment
to the learner.
It lets the learner know that we're there with them,
to help them improve on the work that they're doing.
So, it provides a commitment and
a dedication to learnings that hopefully they will to improve.
And will actually improve with time.
5:37
The other thing is that it, it needs to be a two-way communication.
It should not be just providing feedback.
It needs to be a sharing of this process.
So as we said before, a good communication so that the learner understands what
we mean, and that we understand what the learner intends.
So the final reason that feedback is important is that it needs to
provide guidance.
It should help the learner understand where they're going,
how they're improving, what they're doing.
It should be a road map to where they're going, so that they can improve.
So those are some of the major reasons and the important reasons why we
need to provide feedback, it's to help our learners get better.
So, now let's move on and talk about why feedback is difficult to do.
We're going to move now into where you're going to enter your information and
you're going to your thoughts, about why feedback is difficult.
Sally Santen, M.D., Ph.D.Associate Professor - Emergency Medicine
