Observations over a period of time or for specific purposes (e.g. appraisal, end of attachment interviews) are typical situations when formal feedback occurs in the clinical setting. Teachers may also be required to participate in formal clinical and non-clinical assessments which ideally should incorporate feedback to the learner.

If ongoing feedback has been carried out regularly, then the formal feedback sessions should not contain any surprises for the learners. Feedback can be given on a one-to-one basis or in small groups. The structure for giving feedback will be agreed between you and the learner(s), and may follow one of the models described above. It is also important that both you and the people to whom you are giving feedback are fully prepared for the session.

Prior to a formal feedback session you should:

• ensure the learner is aware they are to receive feedback (so clearly define the purpose of the feedback session prior to or at the outset of the session)
• collect any information you need from other people
• summarise the feedback and ensure you know the positive aspects and areas for improvement are listed (with supporting evidence)
• make sure you know how the feedback relates to the learning programme and defined outcomes.

Setting the scene:

• create an appropriate environment
• clarify your ground rules with the students – what part of the history or examination the student is to concentrate on, when you will interrupt, what other students are to do, how the student can seek help during the consultation, etc.
• agree a teaching focus with the student
• gain the patient’s consent and co-operation
• make notes of specific points.

During the formal feedback session, you should:

• redefine the purpose and duration  of the feedback session
• clarify the structure of the session
• encourage the learner to self-assess their performance prior to giving feedback
• aim to encourage a dialogue and rapport with the trainee
• reinforce good practice with specific examples
• identify, analyse and explore potential solutions for poor performance or deficits in practice.

After the session, you should:

• complete any outstanding documentation and ensure the learner has copies
• carry out any agreed follow-up activities or actions
• make sure that opportunities for remedial work or additional learning are arranged
• set a date for the next feedback session, if required.