More specific feedback: why "confidence" in feedback is too ambiguous.

High quality feedback should be delivered in a timely manner, based on specific direct observation, and formulated to be actionable on the part of the trainee. Utilizing "confidence" as a point of feedback does not meet these criteria given the ambiguity and lack of actionable steps towards improvement. "Confidence"-based feedback makes a judgment about the trainee's internal state leading to potentially gender or culturally biased feedback. There is a risk of emotional harm for trainees when it is integrated into feedback and it is unclear if there is a role for the use of "confidence" in medical education. We are calling for a moratorium on the utilization of the word "confidence" in feedback in medical education until further studies are performed to assess its potential place. At this time, educators should refrain from "confidence"-based feedback and shift the focus towards more specific, actionable, behavioral-based feedback.