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Three Kinds of Feedback

September 11, 2022
by Mark David Siegel

Hi everyone,

In their New York Times bestseller, Thanks for the Feedback: The Science and Art of Receiving Feedback Well, Douglas Stone and Sheila Heen describe three kinds of feedback: appreciation, coaching, and evaluation.

Appreciative feedback acknowledges effort. Showing appreciation builds relationships, encourages hard work, and highlights our values. We show appreciation by complimenting interns for crisp presentations, choosing the right antibiotics, and comforting worried patients. We show appreciation for residents by acknowledging when they lead productive rounds, teach us at Report, and partner with nursing staff. Appreciative feedback shows colleagues they’re valued- that their work matters.

Coaching helps us grow. That’s why we teach interns how to use an ultrasound, ways to streamline notes, and better words to use when counseling patients. Coaching from residents has helped me recognize blind spots, improving my teaching and reminding me to think carefully about the questions I ask on rounds. Coaching is a gift, especially when it’s timely, specific, and actionable.

Evaluative feedback tells us if we’re developing on schedule. It tells us if we’re mastering clinical skills, building knowledge, and approaching professional independence. Examples include the ITE, the Boards, and milestone evaluations. Evaluations can be low stakes (The ITE) or high (The Boards). Think of evaluations as guideposts on the path of your career.

The kind of feedback we give needs to match the kind required. Too often, residents ask for coaching but get cheerleading instead (“Keep up the good work!”). Interns need coaching too, but they also need encouragement, reassurance, and acknowledgement for their work.

I include all three kinds of feedback in my annual meetings with residents. I begin with a summative evaluation, telling residents they’re on track for promotion or graduation, which is almost always the case. We then transition to coaching, considering what’s going well and identifying ways to improve. I always close with an appreciation, thanking residents for their contributions to our patients, community, and residency family.

Appreciation, coaching, and evaluation are all essential forms of feedback. If you’re not getting the kind of feedback you need, ask for it. Next week, we’ll explore what it takes to make feedback successful.

Enjoy your Sunday, everyone. After a bike ride, I’ll be driving to New Jersey to visit my mom, brother, and sister.


Submitted by Mark David Siegel on September 11, 2022