4.4 Models of feedback

There are many models of feedback which have been published. Not all are suitable for every situation, so they need to be picked selectively and used sparingly the trick is to focus on a couple of key points without overwhelming the learner (Hardavella et al., 2017). Below is just a very small selection which are applicable to a clinical setting.

The feedback sandwich

The feedback starts and concludes with positive feedback. The area to be improved upon is sandwiched in between two positive pieces of feedback. This is a really useful tool to use in clinical practice but should not be overused as it can lose its effectiveness. This is because the receiver of the feedback can become aware this style is being used and so may consciously be looking for the negative element of the feedback and ignore the positive aspects of the feedback. So, feedback should be supplemented with positive feedback on its own merits when the opportunity presents itself (Hardavella et al., 2017).

Pendleton model

The Pendleton model promotes a learner-centred conversation where the person receiving the feedback is central and an active participant. The learner has to agree to be an active participant for this model to be effective. It is a process by which the learner and assessor working together reflecting on the action which has occurred. The discussion always commences with the learner (Lucidchart, 2001):

1. Positive areas
   • Learner explains what went well
   • Assessor compliments learner on what went well
   This gives the learner an opportunity to explain the situation in terms of what was being assessed. The aim is to create a safe environment first by highlighting positives and consequently this prevents defensiveness.
2. Improvement area
   • Learner explains what could have been done differently
   • Assessor compliments learner on identifying what could be done differently
   The role of the assessor is to take the area identified as needing improvement and reinforces this as a positive and encourages the learner to suggests what/how the situation could be improved.
3. Action plan
   • The learner and manager agree on an action plan and what could be further improved and how can this be achieved.
   A mutually agreed action plan is formed.

CEDAR feedback model

Another positive and motivating model which can be used is CEDAR (Wildman, 2003).

C – Context. Give the learner context so as they can see how the feedback fits into their overall performance.

E – Example: describe specific examples to illustrate the situation clearly.

D – Diagnosis: help the learner explore why they are where they are. Understanding what’s behind their performance is essential to learning, whether the feedback is about an area of strength or a gap.

A – Action: explore what actions will be important going forward, let the learner lead this part of the discussion as much as possible.

R – Review: following up to support the learner and give recognition for progress.