Consistency is essential for positive changes to become integrated into normal functioning. Acknowledging positive changes reinforces them and stimulates the learner's motivation to continue to become even more proficient in patient care. To help remember the basics and structure for your feedback, some experts suggest "serving the feedback sandwich":

• What was done well?
• What needs to be improved?
• How to make changes?

Remembering to ask for the learner assessment first ensures they are ready to digest the "sandwich" and follow-up verifies it provided benefit.

For those who like mnemonics, we found TOLD AS and IMPROVE as ways to remember the key aspects of feedback.

Feedback should be:

Timely (as soon as possible after the behavior)

Observed (based on your personal observations)

Limited (to a few items, not overwhelming)

Descriptive (expressed objectively as facts, not opinions)

Actions (concerns professional behaviors)

Specific (specific, changeable behaviors)

Giving effective feedback involves:

Identifying objectives clearly before the learning sessions

Making an environment that includes regular, constructive feedback (feedback-friendly)

Performance assessment (directly observed)

Responding to learner self-assessment

Objective, outcome-oriented, information on specific behaviors

Validating what was done well

Establishing a practical plan for follow-up and additional feedback

The bottom line for feedback:

• We work together to care for patients.
• You already do these things well.
• Here's how to make your patient care even better.
• I will keep working with you to become the best possible clinician.