Giving & Receiving
Feedback

Feedback should describe what was observed — not make a judgment about the kind of person the learner is.

Specific feedback targets a single concrete behaviour. It avoids mixing messages, making personal comments, or diluting the message by covering too much at once.

Feedback must focus on behaviours and actions that the learner can actually modify. Commenting on things the person cannot change (height, accent, personality) is both unfair and unhelpful.

Feedback is most effective when given soon after the observed performance. Research consistently shows that the longer the delay, the less impact the feedback has — the event becomes "cold" and the learner's recall fades.

• Aim to give feedback within the same session or day wherever possible.
• However, check the learner's readiness first — if they have just received bad news, had an upsetting consultation, or are clearly distressed, now may not be the right time.
• Both parties should feel calm before beginning a feedback conversation.

Giving a learner five things to work on simultaneously is overwhelming and counterproductive. Research on memory and behaviour change supports addressing no more than one or two priorities at a time.

Choose the most important development point. Address it properly. Save the others for another session.

Feedback should offer possibilities, not commands. When feedback is framed as a suggestion, the learner retains some ownership — which increases the chance they will actually try it.

Focus on exploring the source of the anger — do not mirror it, minimise it, or rush to resolve it.

Return to the observed facts. Keep the language descriptive and non-judgmental. Avoid escalating or trying to "win" the argument.

Acknowledge the external difficulty without letting it become a permanent escape route from the core issue.

Listen actively. Empathise genuinely. Allow time out — postpone further discussion until the learner is settled. Emotional flooding prevents any productive learning.

When resistance persists across multiple conversations, try the following sequence:

Ask the trainee to describe one piece of feedback that genuinely helped them, and one that did not. Use this to explore: What made the difference? What was the environment like? What happened afterwards? This almost always yields rich discussion and sets up the principles of effective feedback naturally.

Ask the trainee to review a recent consultation (or use a COT recording). Walk through Pendleton's structure together. Deliberately ask the trainee to lead with their own strengths — many will try to jump to their weaknesses first. This "pull to negativity" is itself a teaching moment.

Ask the trainee to keep a simple feedback log for two weeks — recording every piece of feedback they receive, the source, how they responded, and what they did differently as a result. Review it together at the next tutorial. This develops feedback literacy and creates evidence for the FourteenFish ePortfolio.

Describe a scenario (anonymised) where developmental feedback was not given, was given too late, or was not received well. Ask the trainee: What went wrong? What could have been done differently? What was the impact on the learner and potentially on patients? This is a particularly powerful exercise for trainees approaching their own training for teaching roles.

This is more common than trainees realise. Some trainers genuinely find developmental feedback uncomfortable to give — particularly with confident or high-achieving trainees. The risk is that the trainee sails through without addressing real gaps that only emerge under exam pressure or in independent practice.

What to do: Create the opening. Try: "I'd really value your honest thoughts on where I could push further — I want to make the most of this placement." If the pattern continues, have an honest conversation with your Educational Supervisor or TPD. This is a legitimate concern to raise.

Your instinct might be to push back immediately. Resist that. Sit with the feedback for 24 hours first. Ask yourself honestly: is there any element that might be even partly true? Even clumsy feedback often contains a kernel worth keeping.

If, after reflection, you still genuinely disagree, raise it calmly and specifically: "I've thought about this a lot — I'm struggling to see this particular point, and I'd like to understand it better. Can you give me a specific example?" Evidence-based disagreement is always welcome. Defensive dismissal is not.

One useful principle: don't dismiss feedback until you've heard it from more than one person. If three different people have said the same thing, that changes the calculation.

This happens to almost everyone at some point in training, especially when feedback touches on something you already privately worry about. It is completely normal. It does not mean the feedback was unfair or that you are in difficulty.

In the moment: It is entirely acceptable to say "I need a moment" or "Can we pick this up tomorrow? I want to give it proper thought." Leaving a difficult conversation for a day does not close it — it improves the quality of the conversation when you return.

Afterwards: Talk to someone you trust — a peer, your ES, or your TPD. Processing feedback aloud with a trusted colleague often reveals that it was more useful than it initially felt.

Patient feedback — whether through the PSQ, a complaint, or a comment passed via reception — can feel very personal. It hits differently from trainer feedback because patients are not trained to give it sensitively.

The same rules apply. Separate the message from the delivery. Look for what is true, even if the framing is blunt. Discuss it with your trainer. One patient's view does not define your practice — but a pattern of similar comments across many patients probably should be taken seriously.

The PSQ is specifically designed to capture this kind of signal. When your Educational Supervisor releases your PSQ results, treat the discussion as a genuinely useful data source — not a performance review to be endured.

A strong feedback-related log entry in FourteenFish describes three things:

1. What happened — briefly. One or two sentences.
2. What you learned from the feedback — specifically.
3. What you did differently as a result — concretely.

The third point is what most trainees leave out. Without it, the entry shows that you were present in a feedback conversation. With it, the entry shows that you learned from it. ARCP panels and Educational Supervisors notice this difference immediately.

No — the RCGP does not mandate a specific model. However, your feedback on COT, CbD, CEPS, and other assessments must be documented in the FourteenFish ePortfolio and should be specific, balanced, and developmental. Pendleton's structure is commonly used for COT and CbD debrief discussions.

This is more common than you might think. Gently create the opening yourself: "I'd really value your thoughts on areas where I could stretch further — I feel like I'm missing some developmental opportunities." If the pattern continues, raise it with your Educational Supervisor or Training Programme Director.

Yes — thoughtfully and professionally. You do not have to accept every piece of feedback uncritically. If something feels unfair or inaccurate, ask for a specific example, seek clarification, or discuss it with your Educational Supervisor. The key is to engage with it rather than dismiss it without consideration.

Peer feedback requires an extra layer of tact — there is no formal power differential, but the same principles apply. The MSF process is the formal mechanism in GP training. For informal peer feedback, the same principles apply: be specific, behaviour-based, and begin from a place of genuine support rather than judgment.

Your Annual Review of Competence Progression (ARCP) panel will review the feedback recorded in your FourteenFish ePortfolio — including feedback from COTs, CbDs, MSF, PSQ, and Educational Supervisor reports. The quality of how you have received and acted on feedback will be visible through your reflective entries and evidence of behavioural change over time.