title: A learning prescription permits feedback on feedback.
abstract: BACKGROUND
  Students consistently identified inadequate feedback as a deficiency in our third-year clerkship.
  
  
  METHODS
  We asked students to solicit one faculty and one resident every 2 weeks for written feedback on a "feedback prescription pad." Each prescription requested four comments: two things the student did well and two things the student needs to improve. Students rated feedback using a five-point scale. A three-point categorization scheme was employed to assess the quality of feedback.
  
  
  RESULTS
  Students' rating of feedback improved significantly compared with a previous time period (3.5 +/- 1.2 versus 2.6 +/- 1.2, P <0.01). Interrater reliability of our categorization scheme was high (kappa > or =0.75, P <0.01) and demonstrated that only 10% of comments were specific enough to qualify as effective feedback.
  
  
  CONCLUSIONS
  Feedback prescription pads were a simple method to facilitate feedback. Although students appreciated feedback, most feedback was inadequate. Faculty development programs to enhance student feedback should be a priority of clinical medical education.
authors.affiliation: Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. jprystowsky@nmff.org
authors.forename: Jay B
authors.initials: JB
authors.lastname: Prystowsky
authors.forename: Debra A
authors.initials: DA
authors.lastname: DaRosa
mesh_terms: D002982:Clinical Clerkship; D004522:Educational Status; D005180:Faculty, Medical; D013502:General Surgery / Q000193:education*; D006801:Humans; D013337:Students, Medical / Q000523:psychology