Questions about feedback

Answer to "Are there models consistent with sociocultural principles that teachers can apply to feedback conversations?"

A recently developed model for feedback conversation, in line with sociocultural principles, is the R2C2 Model. The model is learner-centred and includes four phases: 1. Relationship building; 2. exploring Reactions to the feedback; 3. exploring understanding of feedback Content; and 4. Coaching for performance change The model provides guidelines for feedback conversations that take place in a collaborative, non-threatening way. Different phases of the feedback conversation are distinguished and in all phases using open ended questions is central. The proposed process promotes feedback acceptance and usage. Within a respectful supervisor-learner relationship the main focus of the R2C2 model is on feedback based on coaching for performance improvement, with a written action plan for improvement.

 

Phase 1: Build rapport and relationship

 

Goal: To engage the learner, build relationship, build respect and trust, understand their context

Strategy teacher: Confirm what you are hearing; show respect; build trust; validate.

 

Possible phrases:

  • How has this rotation gone for you? What did you enjoy? What challenged you? How do you think you are doing?

  • Tell me about your assessment and feedback experiences to date. What has been helpful? Or, if this is one of a series of meetings, The last time we met, you were going to do [xxx], how did that work?

  • What do you want to get out of the feedback session?

 

Phase 2: Explore reactions to the performance data

 

Goal: For the learner to feel understood and that their perspectives are heard and respected.

Strategy for the teacher: Be curious and ask open questions to encourage learners to share their reactions.  Validate their reactions.

Possible phrases:

  • What were your initial reactions? Anything particularly striking?

  • Did anything in the report surprise you? tell me more about that...

  • How do these data compare with how you think you were doing? Any surprises?

  • Based on your reactions, is there a particular part of the report that you would like to focus on?

 

Phase 3: Explore understanding of the content

 

Goal: For the learner to be clear about what the assessment data mean and the opportunities suggested for improvement.

Strategy teacher: Ask general questions initially, but be systematic as the session goes on and be sure to address areas of concern to you if the learner does not identify them, perhaps due to lack of insight.

 

Possible phrases:

  • Were there things in the data that did not make sense to you?

  • Is there anything that is not clear?

  • Let us go through section by section.

  • Anything in section “X” you would like to explore further or comment on?

  • Is there anything that struck you as something to focus on?

  • What are your thoughts about “X”? Do you see this as an area to work on?

  • Do you recognize a pattern?

 

Phase 4: Coach for performance change

 

Goal: For the learner to identify areas for change and develop an achievable learning change plan.

Strategy teacher: When the learner understands and has accepted the feedback, coach the learner in identifying priority opportuntites for improvement, and in developing  specific goals and a concrete plan to achieve them. This should include identification of the required activities, resources and timelines, and discussed in a manner supportive of  self-directed learning. 

 

Possible phrases:

  • What do you see as 1-2 priorities for improvement?

  • What would you like to achieve on your next rotation?

  • What 1-2 things would you target for immediate action?

  • What would be your goal for this?

  • What actions will you have to take?

  • Who/what might help you?

  • What might get in the way?

  • What is your timeline?

  • Do you think you can achieve it?

  • How will you know you have been successful?

 

Examples of feedback conversations using the R2C2-model can be found online:

Video 1 uses competency based language: https://youtu.be/_cSDQYjUEok

Video 2 uses generic language: https://youtu.be/-ljhCWYujks

References

Sargeant, J., Lockyer, J. M., Mann, K., Armson, H., et al. (2018) ‘The R2C2 Model in Residency Education:  How Does It Foster Coaching and Promote Feedback Use?’, Academic Medicine, 93(7), pp. 1055–1063. https://doi.org/10.1097/ACM.0000000000002131.

Sargeant, J., Lockyer, J., Mann, K., Holmboe, E., et al. (2015) ‘Facilitated Reflective Performance Feedback: Developing an Evidence- and Theory-Based Model That Builds Relationship, Explores Reactions and Content, and Coaches for Performance Change (R2C2)’, Academic Medicine, 90(12), pp. 1698–1706. https://doi.org/10.1097/ACM.0000000000000809.

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