Faculty Development for Medical Educators

The ADAPT Feedback Model is a structured, learner-centered framework designed to make feedback more effective and less anxiety-provoking. It comprises four main stages: Ask, Discuss/Data Points, Ask/End on a Question, Plan Together.

Steps of the Ask Discuss Ask Plan Together (ADAPT) Feedback Model
	What to Do	What to Ask/Say
Ask	Ask learner to assess own performance; let learner speak first.	“How do you think that went?” “How do you think things are going?”
Discuss/Data Points	Provide 2-3 descriptive, specific, objective observations. The observations should be about the performance/behavior, not about the person	Discuss their answers to your questions.  Focus on: Situation Behavior Impact
Ask/End on a Question	Ask for understanding. Ask for Meaning and/or Growth	Meaning: ”What are your thoughts about that?” Growth: ” What would you like to do differently next time?
Plan Together	How can the learner improve? What tips, recommendations, help can you provide to facilitate their improvement? The plan should be action or behavior-oriented.	”In X time, is there anything you would like to see changed?” “What action might you take?”

Information from: 

• Johnston S, Pauwels J and colleagues; U Washington Konopasek L 2009; NY Presbyterian
• Providing feedback | Faculty Career Development | Office of Academic Affairs | Perelman School of Medicine at the University of Pennsylvania. (n.d.). https://www.med.upenn.edu/oaa/faculty-career-development/providing-effective-feedback.html#Step4PlanTogeth4

---

Below we will look at each step of the ADAPT plan in more detail.

During the Ask step you ask the learner to assess their own performance.  This is important because:

• It sets up a dialogue.
• It assess the learner's insights.
• The learner often identifies areas for improvement.
• You can tailor your feedback to the learner's perceptions.
• The learner can and should be open-minded to new information.

 

What to ask:

• How do you think that went?
• How do you think things are going?
• What is going/went well?
• What are you trying to work on?
• What didn’t go as well as you had hoped?
• What would you do differently next time?
• What was your goal? In what ways were you/were you not successful in achieving that goal?

Learners Self Assessment and Your Observations

The Discuss/Data Points step involves the learner's self assessment as well as your observations.

Your observations should be:

• Specific
• Objective
• Prioritized (2-3 points)
• Descriptive, non evaluative
• About the performance/behavior, not about the person

The video below discusses how to give impactful feedback.

---

Data Points: Blur Words

Convert blur words into data points.

Instead of: “You know you aren’t reliable,…”
Try this: “You said you’d get that note to me by this evening and I still don’t have it yet.”

---

Data Points: Situation and Behavior

• Identify the situation - when and where.
• Describe the behavior - observable action.

---

Data Points: Impact

Explain the impact of the learner's behavior and actions.

Example 1:

• Don't Say: “You said you’d get that note to me by this evening and I still don’t have it yet.”
• Instead Say: “Because I did not get your note, I was not able to complete the patient’s note and the consultant did not have our note at her visit today.”

Example 2:

• Don't Say: “I really liked how you told me about the patient’s living situation.”
• Instead Say “Because you provided specific and important details about the patient’s living situation, we were able to request additional, needed services for a safe discharge.”

 

Data Points: Impact vs Intention

Do: Focus on feelings/values the trainee imparted (impact).

Don't: Attribute feelings and judgement to the trainee (intention).

 

Example of what to do:

• Say: "I felt disrespected when you kept looking at your phone during the meeting." (impact)
• Possible reply from learner: "I apologize my grandma is sick and my family has been updating me."

Example of what not to do:

• Don't say: You were disinterested in our conversation. (intention) 
• Probable reply from learner: Silence. Thinking Wow you don't care about me as a person.

Data Points: Situation/Behavior/Impact

Situation – "During yesterday morning’s rounds, when you gave your presentation…”
Behavior – "I noticed that you weren't able to answer details about the overnight events for two of your patients.”
Impact - Your senior resident had to step in to provide these details. I’m concerned that this may affect patient care when the senior is not present.”

 

Aim for Objectivity

Instead of imparting perceptions and judgements on students simply state what you observed.

Perceptions and Judgements	Observations
"Your patient cried because of how you explained the procedure."	"You explained the procedure, then the patient cried."
"You were rude and disrespectful."	"When you answered the phone call and kept looking at your watch during our meeting, I felt like a low priority and disrespected."
"You seemed really cold, like you didn’t care about the patient."	"I noticed that you didn’t make eye contact and had your arms crossed."

The following statements are helpful to keep in mind when giving feedback:

• I saw
• I noticed
• I heard

For example: “When I saw you deliver the news, I noticed you were looking at the floor and fidgeting with your hands, instead of looking directly at the patient.”

 

Focus on meaning and growth.

Meaning	Growth
What are your thoughts about that?” What questions do you have about what we just discussed?” What part of this discussion was useful to you?”	Anything that struck you as something to focus on?” ”What would you like to do differently next time?”

 

Ending on a question creates commitment rather than compliance and becomes a joint problem-solving situation.

 

Think about what you can do as a coach to help?

Your suggestions should focus on:

• action
• behavior

 

Plan together with the learner.  Ask questions such as:

• “In X time, is there anything you would like to see changed?”
• ”What action might you take?”
• “Next time you do X try to do Y by…”
• “Who/what might help you with this change?”
• 'What might get in the way?”