What is feedback in clinical education?

Objective: Feedback is important in clinical education. However, the medical education literature provides no consensual definition of feedback. The aim of this study is to propose a consensual, research-based, operational definition of feedback in clinical education. An operational definition is needed for educational practice and teacher training, and for research into the effectiveness of different types of feedback. Methods: A literature search about definitions of feedback was performed in general sources, meta-analyses and literature reviews in the social sciences and other fields. Feedback definitions given from 1995 to 2006 in the medical education literature are also reviewed. Results: Three underlying concepts were found, defining feedback as 'information'; as 'reaction', including information, and as a 'cycle', including both information and reaction. In most medical education and social science literature, feedback is usually conceptualised as information only. Comparison of feedback definitions in medical education reveals at least 9 different features. The following operational definition is proposed. Feedback is: 'Specific information about the comparison between a trainee's observed performance and a standard, given with the intent to improve the trainee's performance.' Conclusions: Different conceptual representations and the use of different key features might be a cause for inconsistent definitions of feedback. The characteristics, strengths and weaknesses of this research-based operational definition are discussed.