Swinging the Pendulum from Recipes to Relationships: Enhancing impact of feedback through transformation of institutional culture

Feedback from multiple sources is needed to improve performance and engage in continuous self-improvement. In medical education, it has traditionally been a unidirectional teacher to learner conversation. Recent research suggests that sociocultural factors such as relationships and institutional culture play a central role in the quality of feedback exchanges and impact on recipient behaviour. Our research further advances these insights through exploration of perspectives regarding the influence of cultural factors on feedback. We recommend a dynamic learner-initiated and teacher-facilitated bidirectional exchange of feedback, targeting learner behaviour change. Institutions should promote a feedback culture that normalises strengths as well as deficiencies at all levels, provides a safe space to discuss errors, and promotes longitudinal relationships, feedback seeking, performance observation, and a growth mind-set. In summary, the pendulum of feedback should swing from recipes for giving feedback to relationships for fostering meaningful conversations.