Optimising feedback provision and literacy in medical training: linking theory to practice

Feedback is a cornerstone of all competency-based medical education and training programmes, where learners receive feedback from preceptors on various aspects of clinical performance to attain desired outcomes. However, feedback processes are often suboptimal due to lack of training and expertise of the preceptors in effective feedback provision leading to ineffective feedback that is lacking in timeliness, substance, actionability or palatability. In addition, inadequate feedback literacy in terms of poor self-awareness, affective overlay or lack of motivation to change further limits receptivity to constructive criticisms. In this article, we provide an educational primer on optimising feedback in medical training from both perspectives of feedback provision and reception/literacy. Through a review of common barriers to feedback identified in medical education and practice, as well as pre-existing models of feedback, we developed a novel, practical "reflect-analyse-emote-support" (RAES) framework that could be used for giving feedback in medical training, which not only retains traditional principles and learner-centered structures of feedback, but also incorporates cognitive-behavioral strategies that help navigate natural intuitive, emotive resistance to constructive/negative feedback.