Giving Feedback: The Daily Microdose

One of the most valuable things you can do for a learner is provide brief, specific feedback every day. Feedback does not need to wait until the end of a rotation or require a formal assessment. In fact, learners improve most when they receive frequent coaching based on something that happened during the day's clinical work.

The ARCH framework provides a simple structure for these conversations and can usually be completed in just a few minutes. A one-pager on feedback can be found here.

A – Ask

Begin by inviting the learner to reflect on their own performance.

Try asking:

  • "How do you think that clinic went?"
  • "What went well today?"
  • "What would you do differently next time?"
  • "What was your biggest learning point today?"

Starting with self-reflection helps learners become more aware of their strengths and areas for growth and creates a collaborative conversation.

Tip: Resist the urge to jump straight into your own observations.

R – Reinforce

Identify one or two things the learner did well.

Be specific and describe the behaviour rather than offering general praise.

Instead of saying:

  • "Good job."

Try saying:

  • "You built rapport with that patient by sitting down and allowing them time to explain their concerns."
  • "Your differential diagnosis was well organized and appropriately prioritized."
  • "You recognized the red flags quickly and communicated them clearly."

Specific reinforcement tells learners what they should continue doing.

C – Coach

Choose one area for improvement.

Focus on a behaviour that the learner can change rather than on personal characteristics.

Use clear, actionable suggestions.

Examples:

  • "Next time, try summarizing the patient's concerns before moving into the physical examination."
  • "When presenting patients, start with your leading diagnosis before listing the differential."
  • "Remember to explain your management plan to the patient in plain language."

Avoid overwhelming learners with a long list of improvements. One meaningful coaching point is usually enough.

H – Help Plan the Next Step

End by agreeing on one specific goal for the next clinical encounter.

Examples:

  • "Tomorrow, I'd like you to lead the patient presentation."
  • "Let's focus on developing more concise oral case presentations."
  • "For the next patient, try generating three possible diagnoses before we discuss the case."

This step turns feedback into a learning plan and gives the learner something concrete to practise.

A Two-Minute Example

Teacher: "How do you think that consultation went?" (Ask)

Learner: "I think I missed a few important questions."

Teacher: "I agree there were a couple of things to improve, but first, you did an excellent job establishing rapport. The patient clearly felt comfortable talking with you." (Reinforce)

Teacher: "One thing I'd like you to work on is asking about red flag symptoms earlier in the history so you can narrow your differential sooner." (Coach)

Teacher: "For your next patient, let's make that your focus. I'll watch specifically for that and we'll check in afterwards." (Help Plan the Next Step)

Tips for Success

  • Give feedback as close to the clinical encounter as possible.
  • Focus on observed behaviours, not assumptions or personal traits.
  • Reinforce strengths as often as you identify areas for improvement.
  • Limit coaching to one or two key points.
  • Make feedback conversational rather than evaluative.
  • End with a clear plan for the learner's next patient or next clinical day.

Remember: the goal of daily feedback is not to evaluate performance—it is to help learners improve through frequent, specific coaching. A two-minute conversation every day often has a greater impact than a lengthy discussion at the end of a rotation.