Faculty Development for Medical Educators

There are two essential components of feedback:

1. Set the stage

2. Deliver the feedback.

The first step in feedback is setting the stage.

What is PREPS?

Setting the stage involves PREPS.

PREPS stands for:

• Promote Relationship
• Establish goals
• Pick setting
• Signpost/micro yes

PREPS: Promote Relationship

Build Trust

Building trust with learners is essential! You want to foster a culture of improvement.

Create a Positive Learning Environment

Use the 5:1 rule.  For every one piece of negative feedback give 5 pieces of positive or neutral feedback.

PREPS: Establish Goals

Goals should be:

• Identified by the learner and teacher.
• Revisited periodically (for example: every rotation, every day)
• Specific, clear, and concise.

The instructor should ask questions.  For example:

• "What do you hope to get out of this rotation?"
• "What are you working on?"

The learner should consider their goals and focus and communicate them to their instructor:

• "I'd like to focus on..."
• "My goals for this week on X are..."

PREPS: Pick Setting

• Pick a place that is quiet and private
• Feedback should be timely.  You should address issues soon after they occur.
• Consider your head and heart space.  Be mindful of your emotions before giving feedback, especially when delivering constructive criticism.  Try to remain calm.  Negative emotions can hinder the receptiveness of the feedback.

PREPS: Signpost and Micro Yes

Signposting

Signposting is when the person providing feedback guides the recipient through their comments.  

Why it is important:

• It provides clarity and helps the recipient understand what specifically they are receiving feedback on.
• It gives structure to the feedback that is delivered.
• It reduces anxiety because the recipient knows what is coming next.
• Because of the clarity and structure recipients can better act on your feedback.

How to effectively signpost:

• Provide the agenda up front. 
• Use transitional words or phrases to move between points (examples: first, next, finally).
• Mention specific parts of the person's work or behavior.
• Summarize points.

Micro Yes

A micro yes is a short low-stakes question designed to start the feedback conversation and let the recipient know that feedback is coming.

Examples of Micro Yes:

• “Do you have 5 minutes to talk about how great that conversation went?”
• “I have some ideas of how we can improve your presentation…can I share them with you?
• "Can I offer you some feedback for this rotation?"

The second step in feedback is delivering the feedback.

The Feedback Sandwich is GONE

The feedback sandwich method used to be a very popular method for providing feedback.  With this method a piece of constructive criticism is presented between two pieces of positive feedback.

Why the feedback sandwich is not used anymore:

• It is not effective.
• It is predictable.
• It is confusing.

3 Feedback Models

Instead of the feedback sandwich there are three better feedback models to use: ATA, ADAPT, R2C2

See the separate subpages for more information on each model.

Information received from: Acad Med. 2023;98:648. First published online July 19, 2022 doi: 10.1097/ACM.0000000000004884

Below are resources related to feedback.