Feedback is a core part of medical training, yet studies show that 50% to 67% of learners find it unhelpful, while about half of faculty admit discomfort delivering it effectively. The gap between its importance and its impact explains why a process so vital often fails.
Harika Gorti, MD, an assistant professor at Emory School of Medicine and hospitalist at the Atlanta VA Medical Center, presented a learner-centered approach that blends adult learning theory with practical coaching. She argued that the key isn’t just pointing out weaknesses but encouraging growth through trust, clarity, and relevance.
Effective feedback should highlight strengths as much as areas for improvement. Recognition reinforces excellence, while silence can undermine it. Quality matters more than volume—limiting input to three or four points prevents overwhelm and keeps learners motivated. Gorti warned against the “feedback sandwich,” which often backfires by making praise seem insincere.
Specificity is critical. Input must tie directly to observed behavior and expected standards, ideally linking to real clinical outcomes. Vague or delayed comments feel like judgment, not guidance.
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Common mistakes include a lack of psychological safety, unclear remarks, or missing next steps. Many faculty receive no formal training in delivery. Among these, psychological safety is the most damaging. A warm tone isn’t enough—it requires clear expectations, trust, and letting learners set their own goals.
Learners also struggle. Some treat feedback as a one-way evaluation rather than a dialogue. Others lack the ability to seek, interpret, and apply input. This skill isn’t innate; it can be taught.
Gorti adapted the R2C2 model (relationship, reaction, content, coaching) to address these challenges. Rooted in adult learning theory, it treats feedback as a coaching conversation, not an evaluation. Her version adds self-assessment and collaborative planning.
The model’s steps are simple but intentional. First, rapport establishes safety. She starts by asking learners about past experiences and preferences. Next, reaction exploration lets them process emotions without defensiveness. Content exploration ensures clarity and actionable takeaways.
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Finally, coaching for change turns input into a shared plan, with upward feedback reducing hierarchy.
Adults learn best when they direct their own growth. The R2C2 model aligns with this by letting learners identify gaps and goals, making feedback feel like a tool rather than a threat.
It also normalizes upward feedback.
Feedback doesn’t have to be a source of anxiety. With structure, trust, and a focus on collaboration, it can become what it was always meant to be: a way to grow. Consider a new approach to improve outcomes.
