Supervision in the outpatient context is increasingly in the form of single day interactions between students and preceptors. This creates difficulties for effective feedback, which often depends on a strong relationship of trust between preceptor and student. Building on feedback theories focusing on the relational and dialogic aspects of feedback, this study explored the use of goal-oriented feedback in brief encounters with learners. This study used autoethnography to explore one preceptor’s feedback interactions over an eight-month period both in the ambulatory setting and on the wards. Data included written narrative reflections on feedback interactions with twenty-three learners informed by discussions with colleagues and repeated reading of feedback literature. Thematic and narrative analyses of data were performed iteratively. Data analysis emphasized four recurrent themes. (1) Goal discussions were most effective when initiated early and integrated throughout the learning experience. (2) Both learner and preceptor goals were multiple and varied, and feedback needed to reflect this complexity. (3) Negotiation or co-construction of goals was important when considering the focus of feedback discussions in order to create safer, more effective interactions. (4) Goal oriented interactions offer potential benefits to the learner and preceptor. Goal oriented feedback promotes dialogue as it requires both preceptor and learner to acknowledge and negotiate learning goals throughout their interaction. In doing so, feedback becomes an explicit component of the preceptor–learner relationship. This enhances feedback interactions even in relatively brief encounters, and may begin an early educational alliance that can be elaborated with longer interactions.
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Appendix: Reflection template
Appendix: Reflection template
Date of encounter:
Date of reflection:
Where was feedback given:
Description of experience:
What contributed to the experience?
What background factors influenced the experience?
What are the key issues for reflection in this experience?
What was I trying to achieve?
Why did I intervene the way I did?
What were the consequences of the action for myself? For the learner?
How did I feel about the experience as it was happening?
How did the learner feel?
How did I know what the learner felt?
What internal factors influenced my decision making?
What external factors influenced my decision making?
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Farrell, L., Bourgeois-Law, G., Ajjawi, R. et al. An autoethnographic exploration of the use of goal oriented feedback to enhance brief clinical teaching encounters. Adv in Health Sci Educ 22, 91–104 (2017). https://doi.org/10.1007/s10459-016-9686-5