Dept. of Psychiatry, Southern Illinois University School of Medicine, Springfield, IL, USA.
Acad Psychiatry. 2012 Jul 1;36(4):282-7. doi: 10.1176/appi.ap.11020031.
Timely, specific, behaviorally-based feedback is a cornerstone of medical education. The authors review basic tenets of effective feedback delivery in the context of potential challenges faced by (non-United States) international medical graduates (IMGs).
The authors provide a brief summary of the elements of effective feedback, with illustrations of potential barriers for IMGs.
Many IMGs were trained in a hierarchical system, where feedback was delivered publicly, in a manner associated with shame and embarrassment. These experiences, combined with the challenge of functioning in a second language and anxieties over exposing weaknesses, present some barriers that make it more difficult for them to participate in feedback inquiry, self-reflection, and reciprocal feedback.
These challenges can be mitigated by acknowledging the anxieties that learners may have, fostering a learning culture that values feedback as an expected and important part of all learning, ensuring that all (learners and supervisors) are trained in feedback skills, and clear setting of expectations.
及时、具体、基于行为的反馈是医学教育的基石。作者在（非美国）国际医学毕业生（IMG）可能面临的潜在挑战的背景下，回顾了有效反馈传递的基本原理。
作者简要总结了有效反馈的要素，并举例说明了 IMG 可能遇到的障碍。
许多 IMG 接受的是一种层级式的培训，在这种培训中，反馈是公开的，与羞耻和尴尬有关。这些经历，加上用第二语言进行交流的挑战以及对暴露弱点的焦虑，构成了一些障碍，使他们更难参与反馈查询、自我反思和相互反馈。
通过承认学习者可能存在的焦虑、培养重视反馈的学习文化，将其视为所有学习的预期和重要组成部分、确保所有（学习者和主管）都接受反馈技能培训以及明确设定期望，可以减轻这些挑战。
