Feedback in Medical Education: An Evidence-based Guide to Best Practices from the Council of Residency Directors in Emergency Medicine.
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2023-05
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Abstract
Within medical education, feedback is an invaluable tool to facilitate learning and growth throughout a physician's training and beyond. Despite the importance of feedback, variations in practice indicate the need for evidence-based guidelines to inform best practices. Additionally, time constraints, variable acuity, and workflow in the emergency department (ED) pose unique challenges to providing effective feedback. This paper outlines expert guidelines for feedback in the ED setting from members of the Council of Residency Directors in Emergency Medicine Best Practices Subcommittee, based on the best evidence available through a critical review of the literature. We provide guidance on the use of feedback in medical education, with a focus on instructor strategies for giving feedback and learner strategies for receiving feedback, and we offer suggestions for fostering a culture of feedback.
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Natesan, Sreeja, Jaime Jordan, Alexander Sheng, Guy Carmelli, Brian Barbas, Andrew King, Kataryza Gore, Molly Estes, et al. (2023). Feedback in Medical Education: An Evidence-based Guide to Best Practices from the Council of Residency Directors in Emergency Medicine. The western journal of emergency medicine, 24(3). pp. 479–494. 10.5811/westjem.56544 Retrieved from https://hdl.handle.net/10161/28582.
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Sreeja M Natesan
Dr. Sreeja Natesan is an Associate Professor and Associate Program Director in the Department of Emergency Medicine at Duke University. Her academic mission is centered on advancing clinical teaching and feedback, fostering inclusive learning environments, and transforming medical education through innovation, leadership, and intentional engagement.
Regarding advancing medical education and fostering inclusive learning environments: Dr. Natesan has completed extensive training in clinical education and research, including the ACEP Teaching Fellowship, AAMC Medical Education Research Certificate Program, Academic Life in Emergency Medicine (ALiEM) Faculty Incubator, Duke Educational Skills Longitudinal Mentorship Program, Duke AHEAD Certificate Program, and the AAMC LEAD Program. These experiences have equipped her to lead at the intersection of bedside teaching and faculty development.
She has received numerous awards for educational excellence, including the CORD Junior Faculty Award, ACEP Junior Faculty Teaching Award, CORD Academy Scholar Award for Teaching and Evaluation, and the CORD Academy for Scholarship Education Leadership Award. Most recently, she was honored with the Duke School of Medicine Master Teacher Award (2025).
Nationally, Dr. Natesan serves on the CORD Education Committee, is Co-Chair of the CORD Best Practices Subcommittee, and is the former Chair of the CORD Academy for Scholarship. She also held senior leadership roles with ALiEM, including serving as Chief Academic Officer for the ALiEM Faculty Incubator Program, a global initiative for faculty development in academic emergency medicine.
At Duke, she is the co-founder and director of the Medical Education Leadership Track (MELT)—a longitudinal, interdepartmental "residents-as-teachers" program spanning all GME specialties. Since its inception in 2018, MELT has graduated over 200 residents and fellows. She also serves as Co-Chair of the Duke GME Professional Development Committee, supporting faculty and trainee growth across the institution.
Regarding advancing culture, engagement, and inclusion within MedEd: Dr. Natesan is deeply committed to building inclusive, equitable medical education environments. She is the co-founder and co-chair of the Duke Emergency Medicine Culture, Engagement, and Inclusion (CEI) Committee, which drives departmental efforts to cultivate belonging, address structural inequities, and improve the learning climate.
Nationally, she is the Chair of the CORD DEI Committee and the current President of SAEM’s Academy for Diversity and Inclusion in Emergency Medicine (ADIEM). In these roles, she has led initiatives that focus on holistic review in residency recruitment, implicit bias education, and upstander training to interrupt microaggressions and foster psychological safety. She has delivered invited lectures both within Duke and at national forums such as CORD Academic Assembly and SAEM.
Dr. Natesan also co-developed the CORD DEI Track and a national virtual conference aimed at equipping emergency medicine programs with tools to create inclusive training spaces. Her efforts extend beyond academic settings to community outreach, mentorship, and pipeline/pathline programs, including HPREP, which promote access and opportunity for historically excluded groups in medicine.
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