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Table 1 Exploratory rating framework for written feedback – Feedback Quality Evaluation Form provided to blinded raters

From: Quality of written feedback given to medical students after introduction of real-time audio monitoring of clinical encounters

Weak ■ Lacking performance content altogether
o E.g.“Saw many cases of lung cancer”
■ Blank
■ Nonspecific
o E.g. “A pleasure to work with”, “Functions at PGY-1 level”
■ Irrelevant
o E.g.“Spends much time studying after clinic”
■ Based on second-hand information
o E.g. “Caused pt in Dr. X’s clinic to cry”
■ Predominantly evaluative without specific aim of performance improvement
o E.g.“above average level of knowledge”
Neither weak nor strong ■ Mentions points of good performance in general
o E.g.“Good communicator”
■ Mentions areas for improvement in general
o E.g. “Should take more time with patients”
Strong Specific areas for improvement
o E.g.“Explore symptoms in more depth during review of systems”
■ Based on direct observation
o E.g.“Did not respond to patient comments about anxieties/worries on several occasions – work on questioning further to validate and explore patient concerns”
■ Relevant to course goals
o “When presenting case history, lung cases were better presented than prostate cases. Review prognostic features of CA prostate important in initial consultation discussion”
Explains the gap [between observed performance and explicit standard]
o “At this point in training would be expected to develop a differential diagnosis of at least 3 conditions or etiologies underlying a presenting symptom. Tends to focus only on the most likely cause – encouraged to think of other potential causes as well”