Questions about feedback

Answers to "How can health professions educators enhance the credibility of their feedback?"

Increasingly, effective feedback is defined by its impact on recipients and not by the skills of feedback providers. Of note, research has shown that learners reject feedback if they perceive it as lacking credibility. Given this shift in the perception of feedback, more attention is being paid to the credibility of feedback data.

Factors that appear to affect the perceived credibility of feedback data include:

  • The  perceived interest in the learner and commitment of the feedback provider to the learner’s learning and development

  • The manner of data capture- directly observed vs second-hand

  • The nature of the provider-recipient relationship

  • Congruence or lack thereof with recipient self-assessment

  • Threat to ego or self-efficacy

  • The learning culture


Teachers can enhance the perceived credibility of their feedback using the following strategies:

  • Using direct observation of performance to frame feedback

  • Establishing respect, rapport and a congenial working relationship with their learners

  • Promoting a positive learning environment and establishing expectations for ongoing feedback

  • Providing feedback in a manner that clearly conveys their interest in learner growth

  • Encouraging self-assessment and reflection by learners on their performance

  • Attention to learner self-efficacy and developing competence

  • Supporitng and providing learners autonomy appropriate to level and capabilities

  • Emphasis on ongoing, formative feedback rather than judgemental, summaive feedback




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Sender Liberman, A., Liberman, M., Steinert, Y., McLeod, P., et al. (2005) ‘Surgery residents and attending surgeons have different perceptions of feedback’, Medical Teacher, 27(5), pp. 470–472.

Mann, K., van der Vleuten, C., Eva, K., Armson, H., et al. (2011) ‘Tensions in Informed Self-Assessment: How the Desire for Feedback and Reticence to Collect and Use It Can Conflict’, Academic Medicine, 86(9), p. 1120.

Ramani, S., Post, S. E., Könings, K., Mann, K., et al. (2017) ‘“It’s Just Not the Culture”: A Qualitative Study Exploring Residents’ Perceptions of the Impact of Institutional Culture on Feedback’, Teaching and Learning in Medicine, 29(2), pp. 153–161.

van de Ridder, J. M. M., Berk, F. C. J., Stokking, K. M. and ten Cate, O. T. J. (2015) ‘Feedback providers’ credibility impacts students’ satisfaction with feedback and delayed performance’, Medical Teacher, 37(8), pp. 767–774.

Sargeant, J., Mann, K. and Ferrier, S. (2005) ‘Exploring family physicians’ reactions to multisource feedback: perceptions of credibility and usefulness’, Medical Education, 39(5), pp. 497–504.

Watling, C. (2014) ‘Cognition, culture, and credibility: deconstructing feedback in medical education’, Perspectives on Medical Education, 3(2), pp. 124–128.

Watling, C., Driessen, E., van der Vleuten, C. P. M. and Lingard, L. (2012) ‘Learning from clinical work: the roles of learning cues and credibility judgements’, Medical Education, 46(2), pp. 192–200.