"How Am I Doing?": Many Problems But Few Solutions Related to Feedback Delivery in Undergraduate Psychiatry Education

Abstract

Giving performance feedback to students in psychiatry requires particular delicacy and skill since a critique of the subjective artistry of the psychiatric interview may be felt more personally than a critique of an objective skill, such as eliciting a reflex or applying a stethoscope to the chest. Thus, one would expect that psychiatrists 1) are adept at giving feedback and 2) have written about the nuances of feedback delivery in psychiatric education. After a curricular needs assessment in our program revealed that feedback delivery was being neglected at all levels of training, a review of the medical education literature was conducted to find explanations for preceptor difficulty with performance feedback delivery in undergraduate psychiatric education. A qualitative content-analysis review of the PubMed and OVID literature on feedback delivery and medical education was conducted. Several articles were available on feedback delivery in medical education, but only one of the studies was specific to undergraduate psychiatric education. Several articles offered practical tips to address deficiencies in the feedback process, but there was little to no explanation for the reasons behind the deficiencies. Reasons for the challenges faced by medical students and teachers during feedback conversations have not been fully explored in the literature. In contrast to other areas of medicine, little has been written specifically about feedback to students in undergraduate psychiatric education. Although there are many resources to assist medical educators with feedback delivery skills, an understanding as to why physicians and students struggle with feedback conversations is needed. Reasons for the apparent disconnect between what should be happening and what is actually happening during feedback conversations with undergraduate psychiatry students need to be understood. The authors hypothesize causes for the problems with feedback delivery in undergraduate psychiatric education.