Abstract
Drs. Thomas and Arnold suggest that the provision of feedback is similar to breaking bad news to patients and families. This comparison and the approach they provide expand on previous models for giving feedback in that it explicitly attends to the affect that learners commonly express after constructive feedback is delivered. The key seems to be that, as educators, we need to expect that learners will have strong emotions to feedback. Our job is to help them navigate these emotions in a manner that promotes the learner's ability to keep perspective, reflect, and integrate the feedback.
The ability to provide feedback is a key communication skill for all educators. Experienced educators not only have the ability to communicate feedback but they also have the ability to “know” the learner, that is know the learner well enough to know what constitutes a risk or a developmental leap for that individual learner. This individualized feedback is incredibly constructive and can be perceived as personal. It will often be better received if the educator holds the basic assumption that the learner is trying his or her best.
Drs. Thomas and Arnold provide an approach that will be intuitive to clinicians in palliative medicine. The skills we have developed to talk to patients and families about difficult topics will serve us well in difficult conversations with learners.