7 tips for effective feedback in a clinical learning environment

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Clinical educators will know that when working with learners in the high-pressure environment of a hospital ward or consulting room, considering how feedback is given isn’t always top of the list.

It’s also true, however, that feedback in clinical education is essential for preparing learners for the next phase in their careers as competent independent practitioners.

However feedback is given, it should be a two-way conversation between teachers and learners to achieve the most positive outcomes. With this in mind, here are 7 tips for clinical educators to improve the impact of the feedback they’re giving to students.

1. Build a trusting learning environment

Trust is essential in creating happy, healthy learning environments. And it‘s especially crucial when it comes to feedback. When a learner trusts that a teacher is out to help them achieve their best, the learning experience, and therefore outcomes, can be increasingly positive.

In clinical learning environments in particular, trust can be built upon shared experiences. Teachers in clinical subjects often have the bonus of practical experience in their fields. Drawing on this to share the triumphs and failures from these experiences with students can be invaluable in building trusting relationships, and also respect, in the classroom.

2. Base feedback directly on observations

Research on medicine residents found that trainees tended to discount feedback if they didn’t believe that the statements being made were directly related to first-hand observation.

An effective way to avoid feedback being disregarded in this way is by capturing practice on video and giving feedback on key moments within the recordings. This way, students can physically see exactly where they excelled, and how to improve in future. They no longer have to commit feedback to memory and can review recordings and feedback as and when they require.

Take a look at how Teesside University have implemented our own video recording and tagging software to improve student experiences in clinical simulations.

3. Regularly give effective feedback

However feedback is delivered or received, it should be practised regularly. Feedback should be formative, and making it a regular occurrence will better enable learners to make positive changes to their clinical practice throughout a course.

We may be biased, but VEO is a fantastic way to collate and compare feedback using key video moments over any given period. The tool uses a combination of qualitative and quantitative feedback to build up a picture of a student’s progress.

This way, not only does the teacher have a record of this progress, the student can see how they’ve improved too. The recordings can then be used to seek further feedback from peers or other academics at a later date.

4. Use self-reflection as a starting point for feedback

In clinical training, the ultimate aim is to encourage individuals to become effective self-assessors. Starting feedback sessions with self-reflection can foster this, and makes the overall feedback process more efficient too. Asking students to reflect on their skills and abilities will provide a starting point for constructive discussion around strengths as well as areas for improvement.

Incorporating self-reflection also means that the teacher’s feedback can be targeted to key areas of a student’s performance, rather than making generic statements.

Asking students to feedback on videos of themselves demonstrating clinical skills is a simple and efficient way to replicate this process. Strengths and areas for improvement are then identified by the teacher, who shares their thoughts through a discussion with the student.

5. Make regular feedback part of the culture in your department

We understand that it can be tricky to implement cultural change in education settings, but when it comes to feedback it’s just a case of building on and improving existing processes.

Integrating new technologies with these processes is an easy way to increase the frequency, simply by providing a convenient way to capture and communicate effective feedback.

Using tech such as VEO can also make the whole process more efficient and effective. As we’ve already mentioned, VEO allows users to pinpoint specific ‘lightbulb moments’ within practice so that points for discussion or evaluation are located in just a few seconds. It also means that feedback doesn’t always have to happen immediately after an activity such as a simulation takes place. In this situation the video acts as an effective memory-jogger, there to discuss where and when it is convenient.

6. Build in a plan to improve using feedback

The true potential of feedback comes in what you do with it. Building in a structured plan on how you’re going to implement and measure the impact of feedback is critical to getting those gains.

Are you going to schedule in follow-up sessions? Will you run the same session again to compare and contrast progress? Making a plan is the first step in ensuring students are getting the full benefit of receiving detailed feedback.

7. Reflect on your feedback skills

We’re flipping things on their head here. Of course, education isn’t always about teachers giving feedback to learners, teachers need to improve too.

Feedback can’t be perfect all of the time, so taking time to reflect on how well your feedback is being received and how you can improve is an extremely valuable exercise.

Video can be used in this situation too. Using the same process of filming a face-to-face feedback session, allows for effective self-reflection as well as the opportunity to share feedback techniques and receive feedback from colleagues.

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