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J Gen Intern Med. 2019 Feb 19. doi: 10.1007/s11606-019-04874-2. [Epub ahead of print]

Feedback Redefined: Principles and Practice.

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Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Department of Educational Development and Research and the School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
Department of Medicine and Wilson Centre for Research in Education, Faculty of Medicine, and Mount Sinai Hospital, University of Toronto, Toronto, Canada.


Feedback is defined as a regulatory mechanism where the effect of an action is fed back to modify and improve future action. In medical education, newer conceptualizations of feedback place the learner at the center of the feedback loop and emphasize learner engagement in the entire process. But, learners reject feedback if they doubt its credibility or it conflicts with their self-assessment. Therefore, attention has turned to sociocultural factors that influence feedback-seeking, acceptance, and incorporation into performance. Understanding and application of specific aspects of psychosocial theories could help in designing initiatives that enhance the effect of feedback on learning and growth. In the end, the quality and impact of feedback should be measured by its influence on recipient behavior change, professional growth, and quality of patient care and not the skills of the feedback provider. Our objective is to compare and contrast older and newer definitions of feedback, explore existing feedback models, and highlight principles of relevant psychosocial theories applicable to feedback initiatives. Finally, we aim to apply principles from patient safety initiatives to emphasize a safe and just culture within which feedback conversations occur so that weaknesses are as readily acknowledged and addressed as strengths.


feedback; feedback credibility; feedback culture; residency education; sociocultural theory


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