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July 2020 TLC teaching tip: Should you sandwich your feedback?

There are numerous feedback approaches in literature, but how do you choose which feedback method is appropriate? This month, we take a look at one of the most popular feedback techniques, the sandwich method. 

Numerous feedback methods can be found throughout the literature which can be both helpful and distracting. How do you select the best approach when there are so many options available? We discussed the one-minute preceptor teaching approach in June and examined how that could easily be implemented into a clinical setting. Now let’s take a look at one of the most popular feedback methods, the feedback sandwich. This technique, first described by LeBaron and Jernick in 2000, sandwiches constructive or negative feedback between two comments related to the student’s strengths.  

Check out an example below. 

Positive feedback: You correctly diagnosed a short-term urinary catheter was necessary, and I can tell you care deeply about making the patient comfortable.

Constructive feedback: You need to practice your foley catheter insertion. This patient appeared very tense and this was a missed opportunity to help them relax before you completed the procedure.

Positive feedback: Your patient history was very thorough and your communication skills are coming along. I can tell you have been working hard to improve in this area.


Disadvantages: There has been some criticism in the literature related to this feedback approach.

Take away: The feedback sandwich method has the potential to be an effective approach based on your learning context. Consider using this method, but focus on expanding your feedback approaches to include the learner when possible.

Brown, L. E., Rangachari, D., & Melia, M. (2017). Beyond the Sandwich: From Feedback to Clinical Coaching for Residents as Teachers. MedEdPORTAL: The Journal of Teaching and Learning Resources, 13, 10627. 

LeBaron, S. W., & Jernick, J. (2000). Evaluation as a dynamic process. Family Medicine, 32(1), 13–14.Tuma, F., & Nassar, A. k. (2019). Feedback in Medical Education. In StatPearls. StatPearls Publishing.


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