Giving effective feedback to improve trainee communication skills


  • Krishna Suvarnabhumi
  • Wadee Amraklert


2JJ Communication


Prince of Songkla University, Thailand


Effective communication is one of the core competencies of family physicians. Prior to 2012, trainees were assigned to video record one of their consultations once a month. Video reviews by their colleagues and trainers were conducted every 2 weeks. However, the reviews were often quite critical, and trainees often felt they did not much benefit from the reviews. Moreover, there was no structure of giving feedback. To deal with this problem in 2012 we began using the “Pendleton’s Rules”, a model developed in United Kingdom to improve this kind of feedback situation.

Summary of Work

In 2012, Pendleton’s rules were adopted as a feedback model. With these rules, the trainee would first give some background about the video recording of their consultations, and then the reviewers would ask the trainee what she/ he thought they did well. Then the observers would add what they thought went well in the interview. Then the trainee would make some observations about what went less well and how their interview technique could be improved. And finally, the observers would discuss what they thought went less well and how the trainee’s technique could be improved. During this first year, a focus group of trainees and a focus group of trainers conducted a study to explore the effectiveness of the new giving feedback model. 


We would like to thank all of the participants in the study: trainees and trainers, for the time and help given throughout. Without their participation, this research would not have been possible.


Krackov, S. K.  (2009). Giving feedback. In Dent J. A., Harden R. M. A practical guide for medical teachers. London: Churchill Livingstone.
Pendleton, D., Schofield, T., Tate, P., Havelock, P. (2004). The new consultation. Oxford: Oxford University.
Ramani, S., Krackov, S. K. (2012). Twelve tips for giving feedback effectively in the clinical environment. Medical Teacher, 34, 10, 787–791.


Summary of Results

There were both advantages and disadvantages of using Pendleton’s rules.

Advantages of using Pendleton’s rules:
1. Begin the session with letting the trainee give background and self-assessment.
“I feel like I am confessing a sin, when I give background and self-assessment” (Trainee 1)
“Trainee gets first chance to speak on background to video record of the consultation.” (Trainee 2)
2. Reinforce good or correct poor observed behaviors.
“The trainers gave good feedback about how I sat, which has made me use a better sitting position.” (Trainee 6)
“Other trainees will learn from good and bad communication skills which were discussed in the feedback sessions” (Trainer 4)
3. Make feedback a regular occurrence.
“I think, we should receive feedback again and again till we change to better behavior.” (Trainee 3)
“The feedback sessions are regular and more systematic.” (Trainer 3)

Disadvantages of using Pendleton’s rules:
1. It was difficult for both trainer and trainee to differentiate between what went well and what things need to be improved.
“I have some difficulty in saying what I did well.” (Trainee 7)
 “Some behaviors of trainees may be about good or bad communication.” (Trainer 5)
2. Structured feedback was time consuming. 
“The feedback session using Pendleton’ rules is quite long.” (Trainee 4)



Using Pendleton’s rules in trainee feedback will allow trainees understand better their ability to communicate with patients, and help them improve their overall communication skills.

Take-home Messages

Using Pendleton’s rules can help improve trainee communication skills.

Summary of Work
Summary of Results
Take-home Messages
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