Unlock the Secret to Effective Feedback

In academic medicine, we are surrounded by feedback. It happens in morning rounds, at the end of a clinic, during annual reviews, after a lecture, and in countless informal conversations.

Yet, despite the frequency, most feedback does not create lasting change. 

Too often, it is vague, negative, focused on the past, and leaves you unsure of what to actually do next or just annoyed at being misunderstood.

One framework I have found powerful, and that I now use often with physicians I coach, is the idea of comparing to the ideal version of their role instead of focusing on their actions in the past.

This approach shifts feedback from criticism to clarity, and from judgment to growth. For me, my brain shuts down if you start by telling me what i have done wrong - but if you talk about the ideal behavior your are looking for, I can benchmark my behavior and results against something without feeling attacked.

What it looks like in action

Imagine you are talking to a junior faculty member about research productivity.

Instead of saying:

“You have gotten behind on your research since starting a new clinic.”

You could say:

“Let’s look at what research productivity looks like for someone who wants to lead in our field. You are already publishing, and the next step could be designing a multi-site trial or applying for a K award.”

The first statement focuses on a shortfall in the past. The second paints a picture of what “great” looks like and invites the person to move toward it.

When people can see what the target looks like, and that you believe they are capable of reaching it, they are more likely to feel motivated rather than defensive.

Why this works, especially in academic medicine

Physicians are high achievers. Most of us have spent decades excelling in school, training programs, and competitive fellowships. That track record means we are used to getting feedback tied to performance, but when feedback is vague or framed as a personal shortcoming, it can feel like a threat to our identity.

Shifting the focus to a shared standard of excellence changes everything.

Instead of hearing, “You are not doing enough,” the person hears, “Here is what outstanding looks like, and here is how you can get there.”

This framing works because:

• The target is clear.
  
• The feedback is about behaviors, not personal worth.
  
• The conversation becomes collaborative rather than adversarial.
  

In the high-pressure world of academic medicine, this shift can mean the difference between burnout and buy-in.

Three steps to apply the framework

Whether you are giving feedback to a resident, junior faculty member, or even yourself, you can apply this approach by following three steps.

1. Define the Ideal

You cannot compare someone to an ideal if you have not defined it. Ask yourself:

• “What does ‘great’ look like in this role?”
  
• “What skills, outputs, or leadership qualities would make someone truly stand out here?”
• Make sure you share this vision - even if you have covered it in the past
  

Examples:

• For an educator: look for consistently high evaluations, innovation in curriculum design, mentorship outside of scheduled teaching, and national presentations.
  
• For a researcher: expect steady publication output, securing grant funding, leadership of multi-institutional studies, and recognition as an expert in their field.
  

By describing this vision, you give the person a clear destination to aim for as well as a roadmap to use when prioritizing opportunities.

2. Give Behavior-Based, Forward-Focused Feedback

The power of this framework lies in focusing on actions a person can take next, not simply pointing out gaps.

Instead of:

“You need to improve your national visibility.”

Try:

“To move toward national leadership, consider submitting an abstract to COSM this year and applying for an Academy committee next year.”

This turns feedback into a plan, not a problem.

3. Connect to Shared Values

Feedback sticks best when it is tied to something the person already cares about. That means linking the ideal to their own aspirations.

Example:

“You mentioned wanting to lead a fellowship program. That starts with building a national reputation. Let’s map the steps toward that together.”

When you frame feedback as a bridge between their goals and institutional priorities, you turn it into a partnership.

What this sounds like in real life

Here is an example from a faculty coaching session I was part of.

A junior faculty member had a promising start with several first-author publications, strong teaching evaluations, and excellent clinical outcomes. But they were saying “yes” to every opportunity, from extra clinic days to multiple committees, and their protected research time was shrinking fast.

Instead of saying, “You are doing too much,” the department chair framed it like this:

“If you want to be a national leader in your research area, protecting your lab time is non-negotiable. The people who reach that level are productive because they are intentional about where they focus. Let’s work on creating boundaries so you can protect that bandwidth.”

That is feedback anchored in the ideal, helping someone see what top-tier success looks like and how to move toward it.

Final thought: Feedback as a compass, not a critique

The next time you give feedback, ask yourself:

“Am I comparing them to who they were, or to who they want to become?”

When you anchor feedback to the ideal version of the role, you stop playing the role of critic and start acting as a guide.

You help people align with purpose, measure themselves against excellence, and see a clear path forward.

That is the kind of feedback that changes careers for the long term.

I have been doing this for the last year and found it truly a game-changer, but it takes practice and you may find that your brain still focuses on past performance. Take a minute to reframe before saying it out loud!

Strengthen feedback, engagement, and retention in your department

The Medical Mentor Coaching Faculty Excellence & Retention Initiative brings this and other evidence-based leadership tools directly into your department. Through structured coaching, workshops, and individualized faculty planning, we help leaders give feedback that motivates, clarify career pathways, and create an environment where your best faculty stay and thrive.

If your department is ready to improve engagement, reduce turnover, and develop the next generation of academic leaders, reach out to learn more about the Faculty Excellence & Retention Initiative today.