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Feedback sandwiches affect perceptions but not performance


The feedback sandwich technique—make positive comments; provide critique; end with positive comments—is commonly recommended to feedback givers despite scant evidence of its efficacy. These two studies (N = 20; N = 350) of written peer feedback with third-year medical students on clinical patient note-writing assignments indicate that students think feedback sandwiches positively impact subsequent performance when there is no evidence that they do. The effort necessary to produce feedback sandwiches and students’ unwarranted confidence in their performance impact have implications for teaching about how to give feedback.

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This project was funded (in part) by a National Board of Medical Examiners® (NBME®) Edward J. Stemmler, MD Medical Education Research Fund grant. The project does not necessarily reflect NBME policy, and NBME support provides no official endorsement.

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We are not aware of any conflicts of interest.

Ethics approval

This study received ethics approval from the University of New Mexico School of Medicine Human Research Review Committee.

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Correspondence to Jay Parkes.

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Parkes, J., Abercrombie, S. & McCarty, T. Feedback sandwiches affect perceptions but not performance. Adv in Health Sci Educ 18, 397–407 (2013).

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