Features of effective feedback
Ilhem Mili1,2
, Sonia Trabelsi1, Sonia Mezigh1, Manel Mokrani1,2
, Karl Golnik3, Mejdi Boukari1,2
Contributions: (I) Conception and design: I Mili, K Golnik; (II) Administrative support: S Mezigh, S Trabelsi, M Boukari; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
Abstract: Effective feedback is an essential part of completing and succeeding in education. It is a significant aid to the training of professionals and is increasingly becoming an integral part of any training. The purpose of this document is to describe the characteristics of good feedback. The pedagogical concept of feedback requires it to be non-judgmental and as neutral as possible. This is “specific information that compares the learner’s observed performance to a given standard to improve their future performance”. Understanding the difference between summative evaluation and feedback is essential. While evaluation is based on judgment and a final decision of success or failure, feedback is a positive and constructive action process. Through feedback, the learner will understand if they have achieved their learning goals and how they can achieve them. The role of the teacher is to provide explicit and meaningful information, identify specific areas for improvement, and provide appropriate strategies to achieve this, focusing on the learner’s performance and not on the individual. The six characteristics of feedback include source, connotation, focus level, number of feedback, timing, and determination. The key points of a successful feedback session depend on three main areas: structure, format, and content. Thus, the use of feedback is essential to the learner autonomy and has a major impact on their learning, behaviors, and well-being. Clearly stated, constructive and regular feedback leads changes that are perceived as positive and, in addition, increases the level of engagement of individuals in the organization. Any curriculum should include systematic feedback for every learning session.
Keywords: Feedback; evaluation; assessment; learning; self-regulation
Received: 28 October 2023; Accepted: 23 July 2024; Published online: 02 September 2024.
doi: 10.21037/aes-23-72
Introduction
Feedback is an active process through which a learner receives information about their work. By indicating the deviation from the objective, it generates an action to improve similar or more complex tasks. Feedback helps shape or train professionals, is non-judgmental and as neutral as possible. The purpose of this document is to describe the characteristics of good feedback. For this, we first define feedback and its concept, compare feedback and evaluation and discuss the types of information provided by feedback. Then, we outline the characteristics of feedback, and finally we provide the key points for delivering effective feedback.
Definitions
The definition of feedback has evolved over time, and has had several alternatives, depending on the time period. According to different authors, the definition relates to different components, which, gradually, have been grouped more clearly into a coherent concept today. Feedback is given to improve the subject’s current level of performance to a reference level (1). It may also be considered as an experience, an assessment drawn from an event. Through the 1960s, it was considered that feedback allows individuals to express themselves on their experiences. For Bosc-Miné, feedback indicates whether an action is in line with its objectives (2). As noted by Ramaprasad, feedback indicates the distance between the subject’s current level of performance and a reference level (1). As suggested by van de Ridder, in clinical education, feedback is a specific information, which compares the learner’s observed performance to a standard, given to improve the learner’s future performance (3).
According to Boud and Molloy, feedback is a process by which the learner obtains an appreciation of their work, by comparing their result to that expected through the reference criteria related to this task, in order to correct and obtain a better-quality work (4).
According to Dr. Ende, feedback results in a change in receiver’s behavior (5). In summary, in clinical education, feedback is defined as information formulated by the teacher to the learner about their learning level by observing them performing a professional task, in order to reinforce what they have acquired, or to make corrections based on the difficulties they encounter.
To understand the concept of feedback, it is essential to compare feedback and evaluation. We will only talk here about the summative or sanctional evaluation. Distinguishing feedback from evaluation is challenging due to their similarities, the most significant being: (I) means of communication between learner and teacher; (II) responses to work done; (III) based on learning objectives to be achieved; and (IV) the session is scheduled in advance and expected by both parties.
It is also fundamental to grasp their differences (Table 1). Feedback is about sending a clear message to someone to promote behavior changes that will allow that person to change in order to develop their skills: information based on what the learner did right or wrong, followed by suggestions for correction. In contrast, assessment is a cumulative summary based on evidence, data, and objective observations, in which a judgment is rendered. It consists of a final decision, which cannot lead to any change in behavior, which is diametrically opposed to the feedback process (5,6). There is therefore a final additional essential step in the feedback process: the change in behavior of the learner directly linked to the results obtained, where they improve their performance. This step is under the control of the teacher who must ensure that it is carried out. In contrast, evaluation is a process that provides information after action and ends with the results: it is based on standards and awards a grade or certification according to those standards. The learner may or may not use the results to improve themselves: it is therefore optional here. It is not part of the evaluation process. This is shown schematically in Figure 1.
Table 1
| Concerned items | Feedback | Evaluation |
|---|---|---|
| Intent | Learning | Selection |
| Supports the students in their learning process | Recognizes the degree of mastery of learning or skills | |
| Process | Progressive, continuous | Single |
| Several steps | One-step | |
| Interactive | Non-interactive | |
| Result given to the beneficiary | Information | A judgment |
| Non-judgmental and neutral | A verdict | |
| Descriptive and constructive | No description or explanation | |
| Based on evaluation criteria and solution | Based on evaluation criteria | |
| To what extent the answer it provides is correct or false | Correct or false answer | |
| Reports on the progress of learning and what is responsible for the delay in learning | Checks the mastery of knowledge and skills defined by the programs: success or failure | |
| What is generated | A plan for improvement | A grade, or certification |
| Expected reaction of the beneficiary | Agreement that change needs to occur | Nothing is expected |
| Result on skills to be acquired | Improved | Accepted or rejected |
According to Alarcon, feedback is an integral part of the learning process (7). It provides one or more pieces of information from which the person can work and guide them to train professionally. It determines whether a person has achieved an objective or not. As for evaluation, it is not carried out at a time when the person is able to make changes: it is a final or summative judgment, whereas feedback is supposed to be without judgment and as neutral as possible (7). Feedback is a process, not just information about a performance. This process is active, in which the learner’s role is to search for information, and then generate an action that they use to improve in similar or more complex tasks.
Different types of information are covered by feedback. The typology proposed by Mason and Bruning [2001] differentiates feedback according to the type of information covered: verification and/or elaboration, verification, elaborate feedback, elaborate verification feedback (8). Verification is information about the correctness or incorrectness of the answer and the elaboration includes clues to guide the individual towards the correct answer or towards improving knowledge (9). Verification and elaboration may be informal, as a consequence of natural interactions with physical/social environment, or intentional, provided by a device. Elaborate feedback is provided with a training intention, from an outside source, it is intentional. Elaborate verification feedback provides the opportunity to use information in a new trial or to continue the task. Mason proposed “bug-related” term is interesting because it provides verification and fixes specific errors (8). Thus, feedback places the error at the center of reflection, leading the learner to self-critical efforts to improve their performance. Metacognition, which is the ability to reflect on one’s own learning, is a key element that should be integrated when receiving feedback.
Characteristics of feedback
There are six characteristics of feedback. The first characteristic is the source. It may come from oneself, from a device, or another source. It may be verbal, numerical, symbolic, graphic, or even behavioral. These sources may include oneself, when the learner has a good knowledge of the subject; a device, when the pupil needs immediate and frequent feedback; or a third person, when modulations need to be carried out according to conative characteristics of the learner.
The second characteristic is the connotation: positive or negative. Both can be beneficial for learning: the positive connotation reinforces correct behavior and the negative connotation punishes incorrect behavior (10). Errors are a lever for the progression of learning: they are not failures. They are engines for learning. Convince the learner to accept and play them down is crucial. The teacher employs errors as instrument to aid the learner’s progress. Balance criticism encourages motivation and confidence (11). However, it’s important to be cautious and limit the negative connotations as they can lead to rejection of feedback (8).
The focus level is the third characteristic, which is determined by four factors: the task, strategies, self-regulation, and the person. Process and self-regulation focused feedback is more effective than in person-focused or task-focused feedback. It is important to pay close intention to the significant interaction between feedback on strategy and process improvement feedback and feedback on superficial task information. In fact, the lack of clarification can result in unfavorable interpretation.
The numbers of feedback during the task represent the fourth characteristic. They must be selective, not too numerous, and just two or three things that the student can improve.
The fifth characteristic is the timing: it may be immediate (11) or delayed (12). Immediate feedback is more effective than delayed when learner is learning a new task and lacks expertise. On the other hand, immediate feedback can disrupt operations during a task, especially if it is complex or requires creativity (13,14).
Determination is the last characteristic of feedback. To be effective, feedback must be: (I) planned, taking into account all human, technical, financial, and environmental resources; (II) explicit; (III) descriptive; (IV) behavior-focused; (V) specific; (VI) precise; and (VII) recipient-controlled.
The key points for an effectiveness of feedback
According to Burgess, the success of a feedback session depends on three main areas (15): structure, format, and content. The structure must be clear with a well-defined purpose. Personality-centered feedback is the least effective because it provides little information about the task. The most effective feedback relates to the learner’s performance against predefined objectives and the learner’s self-assessment because it allows self-regulation and can be applied to other tasks.
Programming requires a specific schedule, with a suitable time for both teacher and learner, allowing sufficient time for each to prepare for the meeting. Feedback should focus on knowledge, attitudes, and observed behaviors. The learner evaluates their own learning goals which include both formal and personal goals. The session should include a learner self-assessment and a teacher assessment to jointly develop an action plan.
Regarding the format, this must be adapted to the expected result and must provide both positive feedback and areas for improvement. The teacher prepares to provide relevant elements of the learner’s performance, considering the comments of other team members and selecting several of the most important aspects for improvement. The teacher should provide other situations as examples and actions for improvement.
Concerning the content, time must be reserved for feedback production, where the teacher makes direct observations of the learner’s performance.
Burgess and Mellis (16) summarize nine points required for a successful feedback session by focusing on direct observation and ordering the session through a self-assessment. The elements to be improved must be specific, limited to two or three areas, accompanied by an improvement strategy. They emphasize being positive and ensuring that the learner has understood the entire process. At the end of the session, a document must be provided, and another session scheduled.
Table 2 summarizes the criteria that a feedback session must meet. The most common mistakes to avoid are: judging the person and not the skill, only giving feedback when there has been an incident, giving indirect feedback by email or phone, giving feedback based on findings from a third person and not “one-to-one”, do not propose solutions for improvement. Finally, based on the observation of the learner carrying out a professional task to improve the learner’s performance, it is important to remember that a feedback session must respect the ethical principles of teaching: independence, impartiality, loyalty, integrity, non-discrimination, responsibility, respect for the human person, kindness, empathy, tact, and competence.
Table 2
| Items | What to do | To avoid |
|---|---|---|
| Who does it | The teacher observes the learner | An unmotivated teacher |
| He has the expertise required to evaluate the professional task | Who has not prepared the session | |
| Who does not know the content of the session | ||
| When and where | Throughout the learning, regularly | Learner busy with one of his tasks |
| As soon as possible following the observation, delayed if there are strong emotions | Do it in the presence of others learners | |
| In a calm environment, respect confidentiality | Not taking into account anything that could harm the exchange | |
| Ensure the learner is willing to hear you | ||
| How | Based on factual and concrete observations | Not ensuring that the words have been properly understood |
| Focuses exclusively on remediable behaviors | On assumptions or subjective interpretations | |
| Refers to both positive and negative connotations | Explain briefly or poorly, or not explain what needs to be corrected | |
| Adopt caring behaviors | Not completing the interview | |
| Be attentive and open to discussion | Prevent the learner from expressing his or her point of view or asking questions | |
| Include suggestions and possible solutions | ||
| Respectful and caring wording | ||
| Pay particular attention to verbal and non-verbal language to maximize congruence | ||
| Prepare and structure the session | Taking into account all human, technical, financial and environmental resources | The learner is caught off guard |
| Notify the learner of the session | Carried out under impulsiveness in the face of observed facts | |
| Set the duration of the session in advance | Not ensuring that actions were taken, and that solutions worked | |
| Write down educational objectives: 2–3 points | ||
| Take the necessary perspective on the facts observed to remain objective | ||
| Discuss next steps and monitor progress of the action plan |
Conclusions
The use of feedback is essential to the learner autonomy. It has a significant impact on the learning, behavior, and well-being of learners. It aligns with the act of learning and the process of building knowledge. The statement should be concise, specifying the facts and actions and developing corrective actions with areas for improvement. By being constructive and regular, feedback leads to changes that are perceived as positive and, in addition, increases the levels of engagement of individuals in the organization. Therefore, the curriculum should be purposefully designed to provide systematic feedback for every learning session.
Acknowledgments
We thank Prof. Skander Mrad (University of Tunis El Manar) for his support in this work.
Funding: None.
Footnote
Provenance and Peer Review: This article was commissioned by the Guest Editors (Drs. Karl Golnik, Yip Chee Chew, Gabriela Palis, and Meena Swaminathan) for the series “Improving Teaching Skills in Ophthalmology” published in Annals of Eye Science. The article has undergone external peer review.
Peer Review File: Available at https://aes.amegroups.com/article/view/10.21037/aes-23-72/prf
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://aes.amegroups.com/article/view/10.21037/aes-23-72/coif). The series “Improving Teaching Skills in Ophthalmology” was commissioned by the editorial office without any funding or sponsorship. K.G. served as the unpaid Guest Editor of the series and serves as the Associate Editor-in-Chief of Annals of Eye Science from October 2018 to October 2024 and the unpaid Co-Editor-in-Chief of Annals of Eye Science from September 2024 to August 2026. The authors have no other conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
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Cite this article as: Mili I, Trabelsi S, Mezigh S, Mokrani M, Golnik K, Boukari M. Features of effective feedback. Ann Eye Sci 2024;9:13.
