Harvard Macy Community Blog

Fostering the ongoing connectedness of health professions educators committed to transforming health care delivery and education.

#MedEdPearls March 2018 - "Frame-Based" Feedback

A main learning component of skills and competencies is feedback.   As instructors, when a learner makes a mistake, we jump to the conclusion we know why the learner erred without inquiring about the learner’s thought-processes. “Frame-based” feedback is a strategy to avoid this feedback error and to teach more effectively and efficiently. In an excellent article* about frame-based feedback the authors suggests three quick steps to provide effective feedback while avoiding our own cognitive biases: 1) Provide initial and specific feedback on what you observed; 2) Inquire as to what the learner’s ‘frame of mind’ was; 3) match teaching points with the learner’s frames.

While no one wants to make a mistake and no one wants their mistake pointed out to them, without constructive feedback the learner loses opportunities to improve. As we continue to move toward milestones and competencies in assessment for medical education, we should focus on providing formative feedback to our learners.  


Rudolph J, Raemer D, Shapiro J. We know what they did wrong, but not why: the case for 'frame-based' feedback. Clin Teach. 2013 Jun;10(3):186-9. doi: 10.1111/j.1743-498X.2012.00636.x


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Teaching about Health Equity and Advocacy? Consider the Hidden Curriculum

Our best intentions and goals as health professions educators can be easily undone or reinforced by the hidden curriculum.

As the intern completed her presentation on rounds, she said, “Dr. Campbell, this is Ms. Williams’* third admission in three weeks. She is clinically stable and can be discharged today but I’m worried she will soon be back in the hospital.” Imagine with me two possible scenarios: the first where the team discounts the intern’s fears and pushes for a quick discharge; the second where the team stops to explore what non-medical issues might be contributing to the patient’s readmissions, and works with the social worker to connect the patient with resources that help address those issues. What lesson does the intern learn from scenario one versus scenario two? Which hidden curriculum is at play in each scenario?

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Atipong Pathanasethpong, MD, MS

Address SDoH and fix the hidde...

I'm a firm believer in addressing the SDoH, and we certainly have a lot to improve on this issue. We say we should care for the pe... Read More
Wednesday, 07 March 2018 4:04 AM
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#HMIchat February 2018 – Let’s talk about trust - of the educator

#HMIchat February 2018 co-authors: Leslie Sheu (@lesliesheu), John Mahan (@MedEdMahan), Larry Hurtubise (@hur2buzy)

"I think to be an entrusted educator means that learners respect you, but also are not afraid to be themselves and be honest to you about their questions and needs." - Lindsey Smith (@DrLindseyMSmith)

We were thrilled that trust was the topic of this month’s #HMIchat, and were astounded to learn that this chat brought together 118 medical educators from around the world (including physicians, physician assistants, nurses, and researchers) across multiple specialties (including medicine, surgery, emergency medicine, ICU, physiatry, and pathology, to name a few).

We came out of the chat reinvigorated with thoughts on how to improve our own work and entrustability as educators, ideas on how to study or think about trust in a broader context, and ways to challenge our current framework. We thought we would frame our key take-aways around the 5 factors of trust (watch this video by Justin Kreuter (@kreuterMD) for a great summary!):

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Discouraging Academic Dishonesty using Cognitive Science Concepts

The following blog was co-authored by: Atipong Pathanasethpong and Rosawan Areemit

Academic dishonesty plagues universities around the world, from the US to Taiwan to Australia and beyond. In this blog we would like to discuss ways to address it by employing educational concepts and frameworks to shape a culture and environment that reward honesty and reduce incentives for dishonesty. 

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#MedEdPearls February 2018 - Dialogue-Structured Learning Tasks

The medical education environment offers a variety of opportunities for dialogue education learning tasks.  Dialogue education is an intentional design framework that fosters communication, reflection, and community in the learning environment.   Using this framework, educators can structure dialogue with students through learning experiences or “tasks” designed to assess prior knowledge, introduce new content, give learners a chance to practice, and thenhelp them integrate the new knowledge or skill (Vella, 2000).   Jane Vella’s concept of learning task design includes what she refers to as the 4 I’s: 

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