Clinicians spend a considerable part of their time while supervising trainees providing feedback. It is generally accepted that feedback can play a major role in subsequent academic performance. Traditionally it was thought that all feedback was good feedback, that inevitably improved learner outcomes. This has been challenged and it is now understood that feedback can have a beneficial or deleterious effect on the student. A number of factors can affect a learner's response to feedback. The concept of feedback literacy is helpful to understanding these responses – this describes the processes by which a learner makes sense of feedback and subsequently uses it to enhance learning. A learner who is feedback literate can recognise when they are getting feedback and understand how it relates to their progress; they can process it effectively both cognitively and emotionally, and they can put it in to action in ways which benefit their learning. Modifiable and non-modifiable factors can influence feedback literacy, with modifiable factors including feedback standards and supervisor behaviours. Providing clear feedback expectations, ensuring accuracy of feedback messages and focusing on the relationship between the teacher and learner have the most evidence for their effect on facilitating feedback literacy.
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