In his best-selling book, Thinking Fast & Slow, Nobel laureate Daniel Kahneman describes how humans achieve mastery and develop true competence only in environments where there is frequent, immediate feedback about performance. This is why, he argues, musicians can develop a high-level of skill with 10,000 hours of practice, but stock market pundits have a hard time beating a dart-throwing monkey at a stock-picking game.
At the recent AAMC SGEA conference in Savannah, Georgia, there was much discussion about assessing “soft” competencies like Professionalism, Interpersonal Skills and Communication. These competencies are extremely important for learners to develop, but they often play second fiddle to Medical Knowledge and other hard skills because they’re so tough to measure. Because of this, there was a lot of emphasis at the conference on faculty development and helping faculty recognize and address behaviors that are associated with the softer competencies.
While faculty development is undoubtedly important, most faculty development focuses on helping faculty members become better at assessment. There is much less emphasis on how to increase the frequency of the feedback that learners receive. I would guess that if you were to focus on increasing the frequency of feedback given to learners, you would achieve many of the results that faculty development sets out to achieve, namely:
- Faculty development! By having faculty give more feedback, they in turn get more feedback on what works and what doesn’t
- More discussion about performance between learners and faculty
- A greater proportion of faculty willing to invest time in becoming better evaluators
- A change in faculty mindset from “this is required” to “this is an essential part of what I do”
- Happier learners
If you greatly increase the amount of feedback learners receive, the value of each piece of feedback and the high importance placed on its accuracy goes down dramatically – but the sum total of all the feedback is much higher. In turn, the soft competencies become less challenging to assess and learners get better faster.
So, how can you go about increasing feedback to learners? Here are some ideas:
- Benchmark faculty – You could post the amount of feedback individual faculty give in a public area. This will create an incentive to up the numbers.
- Have learners evaluate faculty on feedback frequency – Relay this back to faculty members.
- Change your evaluation system – Make evaluations are faster, easier to complete, and easy for learners and faculty to generate.
- Designate a central feedback collector – Optimize that person’s role so that they can take feedback from anyone about any learner at any time. For example, if a faculty sees a resident arrive late to a meeting, if she could make a voice memo with her smartphone and email it instantly to the feedback collector, it would significantly lower the barrier to entry to giving feedback.
- Put feedback forms all over the place – Allow anyone (patients, nurses, other healthcare team members) to fill them in anonymously and drop them off
Some of these ideas might work for you, and some may not. What do you think? Let me know what you think in the comments!