Effective Feedback in Medical Education: The Ask-Tell-Ask Model
This is the first article in the Effective Feedback Series, intended to equip medical supervisors with practical tools and tips for delivering guidance to learners during clinical training.
"The function of education is to teach one to think intensively and to think critically. Intelligence plus character—that is the goal of true education."
—Martin Luther King
Feedback is an essential and required component of medical education, providing learners with the insights needed to refine skills and enhance patient care. One effective model for delivering feedback is the Ask-Tell-Ask approach developed by Judith French et al. This model fosters a collaborative environment where the learner actively engages in the feedback process.
The first step in the collaborative Ask-Tell-Ask model is to establish clear agreement with the trainee about the aspect of an activity they would like observed for feedback. This step ensures that the counsel given in step 2 will be tailored to the learner’s specific goals, areas of interest and expectations (which the faculty member can help define). After observing the patient encounter, the educator asks the learner to share their immediate perspective about their experience. This encourages self-reflection and allows the learner to express any concerns or areas about which they felt uncertain.
The second step in the Ask-Tell-Ask approach is delivery of the feedback. Once the learner has shared their perspective, the educator can address the concerns expressed then tell the learner no less than one positive aspect observed during the learning experience, e.g. organized history-taking. This signals areas of competence and accomplishment in learning . Additionally, it is important to tell the learner about 1-2 specific areas for improvement which should be constructive and include actionable steps for future encounters.
The third step in the Ask-Tell-Ask model is to ask the learner what they will do differently in the next encounter. This closes the feedback loop as the learner is asked to think critically about their experience and adopt specific, measurable, achievable and relevant changes to enhance their medical knowledge and clinical skill.
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Citation: French JC, Colbert CY, Pien LC, Dannefer EF, Taylor CA. Targeted Feedback in the Milestones Era: Utilization of the Ask-Tell-Ask Feedback Model to Promote Reflection and Self-Assessment. J Surg Educ. 2015 Nov-Dec;72(6):e274-9. doi: 10.1016/j.jsurg.2015.05.016. Epub 2015 Jun 27. PMID: 26123726.