Training

Asking for feedback in a way that actually gets you some

Omar Samara, MD · 2026-09-21 · 5 min read

The case is closing. You catch the attending at the sink. "Any feedback?"

"Looked good. Nice job."

You walk to the car with nothing. The attending walks to clinic sure they just taught you something.

Your attending thinks they already gave it

This mismatch has been measured again and again.

In 2005, a surgical programme surveyed its attendings and residents on feedback. The authors called the gap in how often it happened, and how well, "a startling disparity".

Seven years later, another group asked the same thing. Residents were less satisfied than faculty with the timing, the amount and the specificity of feedback. Faculty rated feedback as more frequent than residents did in all seven areas of competency they asked about.

A 2020 survey of 83 general surgery residents added detail. 93% had received some feedback in the past year. But 46% said they got it 20% of the time or less.

Then the number worth remembering. 78% said attendings clearly said "this is feedback" 20% of the time or less.

One more study helps explain it. Residents and attendings were shown the same written teaching scenarios and asked which ones counted as feedback. Their answers did not differ.

So this is not a fight about what feedback means. A lot of it is said in passing, never labelled, and never heard as feedback at all.

Feedback is not automatically good for you

This part surprises people.

A large meta-analysis pooled 607 effects from 23,663 observations. On average, feedback helped. But over a third of the feedback interventions made performance worse.

The authors' explanation was about attention. Feedback worked less well the more it pulled attention away from the task and towards the self.

The practical reading is simple. "How did I do?" asks for a verdict about you. "What should I change about the releases?" keeps it on the task. The second question is also easier to answer.

Why "any tips?" gets you nothing

Your question sets the size of the answer.

A broad question makes the attending do all the work. They have to replay the whole case, choose what matters, and then say something critical to your face. The cheapest answer is "looked good".

Residents in focus groups named the barriers themselves: attendings who seem unapproachable, time pressure, and discomfort with giving negative feedback. The big facilitator they named was the learner getting involved in the process.

There is a less comfortable reason too. A UK focus group study of 42 surgical trainees found that when a workplace assessment felt like a test, trainees "played the game". They went looking for praise and avoided criticism. But it was the negative feedback that actually changed how they practised.

Be honest with yourself here. "Any tips?" is sometimes a request for reassurance dressed up as a request for feedback.

A structure that has been tested

One group built a five-prompt debrief for the operating room called SHARP:

• Set learning objectives, before the case.
• How did it go?
• Address concerns.
• Review learning points.
• Plan ahead.

They observed 100 cases with 22 attendings and 30 residents, 50 cases before the tool and 50 after. Debrief quality, scored by a trained observer, went from a median of 19 to 33.

It was a before-and-after study, not a randomised trial, and the tool was taught as part of the study. Still, look at where the first prompt sits. It happens before the case. That is the one part a resident can start alone.

What to actually say

• Before you scrub, name one thing. "Today I am working on my releases. Can you watch that part?" Now the attending knows what to look for, and it is part of the ask from last week.
• Ask about a step, not the case. "On the second anchor, what would you have done differently?" A small question gets a real answer.
• Ask for one change, not a grade. "What is one thing I should do differently next time?" It keeps the answer on the task.
• Label it. "Can I get two minutes of feedback on the exposure?" Now you both know it happened.
• Ask soon. At closing or at the sink, not three days later in the corridor. Trainees find immediate feedback more useful for learning.
• Take the negative without arguing. Say thank you. If you defend yourself, you teach them not to bother next time.
• Ask your senior too. In the same 2020 survey, 78% of residents said feedback from seniors and chiefs was as valuable as feedback from attendings, or more.

Then write the one change down before the next case with that attending. Feedback you cannot find again does not count.

OrthoVaultOS keeps notes against each procedure and a preference card for each attending. Put the change there, next to the step it belongs to. Next time you open that procedure before a case, it is the first thing you see.