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Educators in academic surgery on giving and receiving feedback

May 15, 2024
by Elisabeth Reitman

Despite its importance, clinical trainees often feel that they receive infrequent or inadequate feedback. As part of a series on the issues and opportunities facing medical educators in academic surgery, the Yale Department of Surgery spoke with four faculty about barriers to the feedback process and tips for making feedback part of institutional culture.

Despite its importance, clinical trainees often feel that they receive infrequent or inadequate feedback. The opportunity to guide medical students is a privilege that comes with unforeseen challenges. R. Peter Manes, MD, Saral Mehra, MD MBA, Kelly Olino, MD, and David Stitelman, MD, who were voted as top educators by the Yale School of Medicine's Class of 2024, share reflections on the role of academic surgeons in shaping medical education.

How do you approach giving and receiving feedback to students in real time?

Find strengths and areas for improvement

R. Peter Manes: I always try to find both strengths and areas for improvement in a learner’s feedback. Everyone has something they do well, but everyone also has things they can work on. Highlighting both of these helps to give a learner a positive experience while still setting appropriate expectations for improvement.

Dr. Manes, associate professor of surgery (otolaryngology), serves as the associate residency program director for the Division of Otolaryngology and the clinical site director for otolaryngology.

Think through problems

Saral Mehra: Feedback is hard to give when you may only be with any specific student for a short amount of time. I like to ask a lot of questions, to see what students know; many of these questions are basic surgical questions (not specialty specific). As I ask questions, I give feedback on how they answer the question and think through the problem – not just whether or not they got the correct answer.

Dr. Mehra specializes in head and neck cancers. He is an associate professor of surgery (otolaryngology), and chief of the Section of Head and Neck Surgery within the Division of Otolaryngology. He also serves as the Fellowship Director for Head and Neck Oncologic and Reconstructive Surgery.

Explain why every detail is important

Kelly Olino: I view feedback as a continuous conversation throughout an operation or clinical encounter. When you continue to talk and be engaged with the student, they get a balance of both positive and negative feedback which balances out each experience for them. I think it is also important to explain why every detail when taking care of a patient is important and how even something like cutting a suture the correct way can have important consequences.

Dr. Olino is an assistant professor of surgery (oncology), who specializes in the care of patients with advanced skin cancers and sarcomas. She is the clinical director of the Smilow Melanoma Program at the Yale Cancer Center and the medical student clerkship liaison for Division of Surgical Oncology.

Show, explain, and discuss

David Stitelman: For the clerkship, several students ask for me to evaluate the written H&P/Consult note. It is easy to discuss the different forms of documentation used by different providers in different settings. This is also a time to discuss honesty and the pitfalls of EPIC. In clinic, I have students meet and examine patients and present those cases. This is an opportunity to discuss differential diagnosis and synthesis of assessment and plan. In the OR, we give students small tasks initially and allow them to do more as they show competence or enthusiasm. Feedback for technical skills (suturing, removing ports) is often a mix of showing, explaining and discussion of how things went.

Dr. Stitelman is an associate professor of surgery (pediatrics) and the surgical director of the Yale Fetal Care Center. He is also the recipient of the 2018 C Elton Cahow Teaching Award for outstanding faculty teaching.

Submitted by Elisabeth Reitman on May 09, 2024