My experience as an educator began as a learner, and one foot will always remain firmly planted in that role. The “golden rule” of my educational philosophy is to respect learners' need for self-determination, treating them as active and valid participants in their own education, incorporating prior experiences and seeking to understand their current goals and desires. I believe learners in medical education have already demonstrated that they have the intelligence and capacity to learn the material at hand hundreds of times over to get where they are. Challenges arise when the aims and expectations of learners, educators, and the education system are not aligned, even when on the surface they appear so. For this reason, feedback is of the utmost importance in education and consistently giving effective formative feedback to learners must be our primary goal.

Aligning goals between learner and educator necessitates identification of the goals of both, which in turn requires close and frequent evaluations of the context of our specific educational programs. What strengths and resources can we capitalize on in supporting our learners to their goals? What challenges exist in the local learning environment that we should expect to help our learners navigate? Are we certain that our assessment methods continue to be the most valid to assess performance, and how do we reduce their limitations? Where are our biases, and how could they be getting in the way of helping learners reach their full potential? Performance on a single assessment, or series of assessments, may be as indicative of the strengths and weaknesses of the educational program as it is of individual learners. In the world of competency-based education, checking boxes is no longer the gold standard. We are entrusted with training medical professionals - we must continually challenge and innovate within our education programs to respect and deserve that trust.

I am still early in my career. I know that my educational philosophy is not yet fully developed and set in stone; in fact, I prefer that it remain malleable and responsive to the experiences and learning I have yet to encounter. As mentioned above,  I believe context is key - and the context of medical education is constantly evolving. I aim to remain connected to learners by ensuring that I continue to experience the learning environment firsthand. In practical terms, this requires a robust clinical practice as well as active teaching and assessment of learners, a role in the residency leadership team, and ultimately a concurrent focus on program-level evaluation of strengths, opportunities for improvement and learner needs.

My co-fellow and I were asked to formulate a longitudinal program involving integrating interns into residency, helping them form connections with faculty and residents and pointing out the "hidden curriculum" of residency whenever possible. Exploring what the "hidden curriculum" actually was constituted the majority of our needs assessment and necessitated recruiting a relatively broad group of stakeholders, from residency leadership and residents to administrative staff, departmental leadership, fellows, and core faculty in the department.

The various needs identified ranged from time management and organizational skills to managing difficult interpersonal communications and personal and organizational leadership. With limited time and resources, and topics which often had little if any precedent in the literature we searched in medicine, we had to get creative in our curriculum design - and ensure that our curriculum had the structure and flexibility to collect and respond to evaluation data and feedback.

Professionalism curriculums that we identified in our background educational search focused on gaps which we did not identify in our own needs assessment. For example, navigating ethical quandaries or confronting substance use issues were addressed in several professionalism curricula that existed, but none of our stakeholder groups had identified these issues as gaps. Furthermore, despite recruiting the various stakeholder groups during our needs assessment, we still had limited resources (including our own expertise and budget) and needed to keep these stakeholders meaningfully engaged throughout the year-long curriculum for it to feasibly achieve its goals.

We utilized Kern's six steps of curricular development to guide our needs assessment and subsequent goal formation and delivery plan; the Kellogg foundation's logic model helped us match the resources we had available to appropriate activities for delivery of our instruction, track outputs of these activities and ensure they were matching up to outcomes and long-term desired impacts. Finally, we had to develop organizational leadership skills to orchestrate all these pieces and keep stakeholders engaged - so we reached into the world of business and took leaves out of Kotter's book(s) to lead change.

Critical Review - Feedback Models vs Education Theory

Collaboration with multi-institutional research team

This critical literature review, conducted using COVIDENCE and utilizing PRISMA flow for article selection, evaluates the existing models for feedback in medical education literature for their alignment with several major education theories. Well-known models like the Sandwich Model often lack any grounding in actual education theory; other models claim to be models for giving feedback but on closer examination actually function as models for teaching, coaching, or other education pursuits and not specifically for feedback. By collating a list of the existing models, giving a brief description, and creating visual representations of alignment with various well-known education theories, we produce a reference for medical educators to use in selecting a feedback model which is both appropriate for their context and grounded in educational theory.