Best Practices in Formative Feedback in Resident Evaluations: A Narrative Review

BACKGROUND

Formative feedback is essential for the optimal development of a physician. The narrative portion of the evaluation is uniquely poised to help guide the resident. However, the quality of the feedback may be highly variable, and evaluators may be hampered by both a lack of formal training as well as time pressures.

OBJECTIVE

To determine best practices in providing narrative feedback for residents.

METHODS

We conducted a narrative review of the literature around formative feedback in residency using a Pubmed search of articles written in English over the 30 year span 1993-2023.

RESULTS

Several themes were identified. Comments should be specific, both to the task and to the individual. Commentary should also be actionable, rather than a statement of what cannot be changed by the learner. Ideally, the narration should be constructive, and strike the proper tone. There are additional operational items, such as the structure of the evaluation form itself, that may help optimize narrative commentary.

CONCLUSIONS

There is limited but compelling evidence that narrative commentary can be improved in educational value by being specific, actionable, constructive, and written with the proper tone. Changes in the evaluation form may optimize quality and improve timing of delivery.