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Abstract

We thank Dr. Rieves for the comments on our article.1Buckley C. Natesan S. Breslin A. et al.Finessing feedback: recommendations for effective feedback in the emergency department.Ann Emerg Med. 2020; 75: 445-451Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar We agree that feedback may be inhibited by both the giver and the receiver, with feedback triggers playing a particular role in the latter group.1Buckley C. Natesan S. Breslin A. et al.Finessing feedback: recommendations for effective feedback in the emergency department.Ann Emerg Med. 2020; 75: 445-451Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar Similarly, we agree that the growth mind-set is necessary in a learner and appreciate the addition of the concept of grit. We also appreciate the suggestion of mental contrasting with implementation intentions and the wish, outcome, obstacle, plan models as a means to help express a learner’s self-reflection and goals. We can imagine that it may be difficult, particularly in emergency medicine, for residents to come up with a new wish, outcome, obstacle, plan model for each shift, especially because they may be working with a new attending physician each time. Consequently, we suggest the attending physician assist with this by providing goal suggestions or having the learner e-mail his or her goals ahead of time. Incorporating wish, outcome, obstacle, plan models would be an easy next step in this process by simply adding perceived obstacles and plans that could be discussed before or even during the shift. It is important to remember that parts of the wish, outcome, obstacle, plan approach can be heavily influenced by learner-specific factors. People who enter a situation with high expectations of success enact more goal-directed behavior when faced with an obstacle than people with low expectations of success.2Kappes A. Singmann H. Oettingen G. Mental contrasting instigates goal pursuit by linking obstacles of reality with instrumental behavior.J Exp Psychol. 2012; 48: 811-818Google Scholar Therefore, it is important to encourage high expectations of success when guiding self-reflection. Feedback providers should know that residents who are struggling with imposter syndrome may particularly struggle with low self-esteem and lower expectations of success.3Gottlieb M. Chung A. Battaglioli N. et al.Imposter syndrome among physicians and physicians in training: a scoping review.Med Educ. 2020; 54: 116-124Crossref Scopus (62) Google Scholar This may be particularly prevalent among female residents and those underrepresented in medicine, for whom external biases and challenges to their self-identity can be a threat to their success.3Gottlieb M. Chung A. Battaglioli N. et al.Imposter syndrome among physicians and physicians in training: a scoping review.Med Educ. 2020; 54: 116-124Crossref Scopus (62) Google Scholar,4Cohen G. Garcia J. Identity, belonging, and achievement: a model, interventions, implications.Curr Dir Psychol Sci. 2008; 17: 365-369Crossref Scopus (210) Google Scholar Consequently, feedback providers should be aware that learners may face multiple conscious and unconscious obstacles to their development. For feedback providers, it is important to ensure that corrective feedback is provided with an emphasis on targeting an expectation of success, with focused and achievable goals. This will help foster a growth mind-set while tailoring the goals to the learner. Whether one uses the wish, outcome, obstacle, plan approach or another feedback tool, we believe that it is most important to establish a safe and trusting relationship, target the feedback to the learner, and ensure that goals are focused and achievable. Finessing Feedback: Recommendations for Effective Feedback in the Emergency DepartmentAnnals of Emergency MedicineVol. 75Issue 3PreviewFeedback is important in all professional fields,1-3 but can be challenging to adequately provide and receive. Because residency is a time focused on education, feedback is an essential component, providing a means for development through learning from mistakes and successes.2,4-7 Feedback has been recognized as one of the key factors in enabling effective learning in health professionals and is considered a critical component of learner development.8,9 In fact, the Accreditation Council for Graduate Medical Education has declared feedback to be an “essential and required” part of resident training. Full-Text PDF Translating Feedback to Action Through Self-reflectionAnnals of Emergency MedicineVol. 75Issue 5PreviewProfessional growth in emergency medicine is continuous and lifelong. Requisite skills such as giving, receiving, and incorporating feedback into practice must be refined throughout our careers. Several best practices surrounding effective feedback in emergency medicine were described in the recent publication by Buckley et al1 titled “Finessing Feedback: Recommendations for Effective Feedback in the Emergency Department.” The corollary to these recommendations is the responsibility of the learner to translate feedback into meaningful behavioral changes. Full-Text PDF