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Plus/Delta Card Technique for Clinical Feedback

This useful tip comes from the Community Faculty Development Center at the University of
Massachusetts Medical School. It is a means of making frequent, brief observations of student
performance and delivering balanced, specific feedback to improve their performance.
Hold a 3x5 or similar sized card vertically and draw a line down the middle of the card. On the
top the card, left of the line, draw a “+.” On the top right, draw a “∆.“ It should look like this:

plus/delta card depiction, 3 by 5 card with2 columns, left column with plus sign at top, right column has delta sign at top

Now, each time you observe your student, write down at least one thing you observed them doing well that you want them to continue and at least one thing you would like them to do differently or stop doing. Make a habit of brief observations while they are collecting a history or performing an exam or procedure. Review your observations with them as soon as your schedule allows, perhaps even several times a day. The idea is frequent, brief observations and feedback. This tends to help students improve more quickly than longer, less frequent observation and feedback. A bonus is, by keeping the cards, you will find you can complete your formal evaluation at the end of the rotation much quicker and with better comments than otherwise.

Scott Moser, M.D.
Nov. 21, 2012

Reference:
Qualters DM. Observing students in a clinical setting. Fam Med 1999;31(7):461-2.

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