Feedback in Medical Education: An Evidence-based Guide to Best Practices from the Council of Residency Directors in Emergency Medicine
ABSTRACT
Within medical education, feedback is an invaluable tool to facilitate learning and growth throughout a physician’s training and beyond. Despite the importance of feedback in medical education, variations in practice indicate the need for evidence-based guidelines to inform best practices. Additionally, time constraints, variable acuity, and workflow in the Emergency Department (ED) pose unique challenges to providing effective feedback. This paper outlines expert guidelines for feedback in the ED setting from members of the Council of Emergency Medicine Residency Directors Best Practices Subcommittee, based on the best evidence available through a critical review of the literature. This paper provides readers with guidance on the use of feedback in medical education, with a focus on instructor strategies for giving feedback, learner strategies for receiving feedback, and suggestions for fostering a culture of feedback.
BACKGROUND
Feedback is an important tool within medical education for the improvement of clinical skills and professional development.1 However, the Emergency Department (ED) presents a uniquely complex environment for feedback due to the rapid pace and workflow for patient care, relative lack of privacy, and need for constant task switching.1 Incorporating feedback into this environment can negatively impact an Emergency Medicine (EM) resident’s training, with consistent reports of dissatisfaction regarding the quality of feedback received from faculty.2 The Accreditation Council for Graduate Medical Education (ACGME) Milestones reported that important domains for high-quality feedback should include timeliness, specificity, balance, recipient feedback/reflection, and an action plan.1,3–31
Despite the importance of feedback in medical education, evidence to inform best practices in the ED is limited and there is a need for evidence-based guidelines to optimize feedback within the ED setting.2,32 Based on the best available evidence through a critical review of the literature, we offer expert guidelines on feedback from members of the Council of Residency Directors in Emergency Medicine (CORD) Best Practices Subcommittee. This manuscript provides readers with recommendations on the use of feedback in medical education, with a focus on giving and receiving feedback, and suggestions for fostering a positive culture of feedback.