Let me give you some feedback...

Before 1997, "feedback" to me was the term used for the loud screeches which were the result of  a microphone receiving input from its speaker. When I started at Medical School, the term "feedback" is what you left for lecturers at the end of trimester. This seemed a pointless exercise of trying to remember who gave a lecture 8 weeks ago and what they were like. The situation was made worse by the fact that there seemed to be no obvious consequences to our feedback.

We ask for feedback from all of our courses (the wisdom and utility of this will no doubt be the topic of another post) and on Friday I received feedback from one our own faculty who sat in on my debrief.

I have been a strong proponent of feedback in simulation-based medical education (SBME) for a few reasons:

• Equitability: Facilitators will happily spend many hours giving feedback (via facilitated debriefing) to the course participants. Why should they not then receive feedback on their own performance?
• Expertise: Expertise comes about through deliberate practice of a skill with feedback
• Reflection: Good (constructive, informed, timely as opposed to positive) feedback should lead to reflection on practice

The problem I have with getting feedback is that I still find it difficult not to explain away any negative observations. Too often I find myself saying: "Yes, well, he was a difficult candidate...." "Yes, but that wasn't my fault..."

Giving good feedback can be hard, but receiving feedback is always more difficult. Over the years one of the things I have learnt to do is to not say anything when receiving feedback (I don't mean to give them the silent treatment!) Instead I try and listen and take the comments as a genuine endeavour to improve my skills.

One of the observations from my colleague is that I occasionally use a scattergun questioning technique: "So what were you thinking? What was happening? Why do you think this happened?" The excuse on the tip of my tongue is that I get excited when debriefing and want to help the participants as much as possible by pushing/pulling them along. However, the correct response is that this is true, that scattergun questioning is not the  correct way and that silence and pauses are very effective in debriefing.

So, are you getting feedback on your feedback? And if not, why not?