Hi everyone,
The term “constructive feedback” is often used euphemistically to list a resident’s shortcomings, as in “here’s what they do well and here’s where they get constructive feedback.” If a resident gets no constructive feedback, it’s implied that all is peachy- just another perfect Yale resident being perfect.
Misunderstanding about constructive feedback pervades MedHub, where the most common suggestions for improvement include “nothing,” “N/A,” and “keep doing what you’re doing.” But these meaningless comments miss the point- they’re only vaguely encouraging, they’re not believable, and they don’t help residents grow.
We all need constructive feedback. We need to help residents fill knowledge gaps by pointing them to classic studies and practice guidelines. We need to help them build skills by suggesting they practice EKG interpretation and review radiographs. We need to improve communication by suggesting less jargon, like saying “cancer” instead of “neoplastic process.” We should encourage residents to lead family meetings and tap into Care Signature Pathways. We should remind them to delete outdated information from their notes and empty their inboxes. We should prompt aspirational goals like encouraging interns to lead rounds and PGY3s to adopt the attending role.
Because the term “constructive feedback” is often misused, residents may worry that suggestions for improvement imply that they’re failing. To avoid confusion, I always pair constructive feedback with reinforcing feedback like saying “your knowledge of cardiopulmonary physiology is advanced” or “your notes are crisp, accurate, and concise” or “I love the compassionate way you speak to patients.” I also routinely provide summative feedback so residents know where they stand: “your performance is what I’d expect of a Yale PGY2.” And if they’re falling short, I say that too, because residents need and deserve to know if they’re not on track.
Constructive feedback is an essential tool to be shared generously, both verbally and in writing. It’s never constructive to say “N/A,” “nothing,” or “keep doing what you’re doing.” Instead, let’s be detailed, specific, practical, and thoughtful so all residents can become the skilled, competent, compassionate physicians they’re meant to be.
Enjoy your Sunday, everyone. I’ll be hiking up East Rock before reading residency applications for next Tuesday’s interview day.
Best,
Mark
P.S. If you haven’t sent in your entry yet for our annual Thanksgiving Program Director’s Note, now’s the time! What are you thankful for? Tell me by Tuesday night!
P.P.S. Recommended reading: Thanks for the Feedback by Douglas Stone and Sheila Heen
P.P.S. What I’m reading, watching, and listening to:
- James by Percival Everett
- Vaccine Conspiracies, Fluoride Myths, and America’s Broken Public-Health Discourse: Emily Oster on Plain English with Derek Thompson
- Scientists must hold President Trump to account with courage and unity in Nature
- "Show Me Sand The Floor" | The Karate Kid (1984) H/T to Cindy McNamara