• Karen E Broquet and Manisha Punwani.
• Dept. of Psychiatry, Southern Illinois University School of Medicine, Springfield, IL, USA. kbroquet@siumed.edu
• Acad Psychiatry. 2012 Jul 1; 36 (4): 282-7.

ObjectiveTimely, 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).MethodThe authors provide a brief summary of the elements of effective feedback, with illustrations of potential barriers for IMGs.ResultsMany 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.ConclusionsThese 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.

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