Resources for Faculty Teaching M4 Students

giving feedback resources


Ask-Tell-Ask Feedback Approach

When giving feedback in the clinical setting, the ask-tell-ask feedback approach is an effective way to provide feedback.  Through this approach, learners are first asked to reflect on their performance during a clinical encounter.  The preceptor then provides feedback and specific examples of what was observed, highlighting positive behaviors and future improvement opportunities.  Finally, the learner is asked to identify ways to improve and an action plan is agreed upon for the future.  Ende (1983) offers clinical feedback guidelines incorporated into the ask-tell-ask approach and Bienstock et al. (2007) provide specific phrases that might be used with the learner during the feedback session.

The following short 3 ½-minute video from Virginia Apgar Academy of Medical Educators, Columbia College of Physicians and Surgeons, provides a great overview of the ask-tell-ask feedback approach.



Bienstock, J. L., Katz, N. T., Cox, S. M., Hueppchen, N., Erickson, S., & Puscheck, E. E. (2007, June). To the point: medical education reviews – providing feedback. American Journal of Obstetrics & Gynecology, 196(6), 508-513. doi: 10.1016/j.ajog.2006.08.021

Ende, J. (1983). Feedback in clinical medical education. Journal of the American Medical Association, 250(6), 777-781.

Virginia Apgar Academy of Medical Educators, Columbia College of Physicians and Surgeons. (2014, June 18). Quick teaching tip: Feedback. [Video]. YouTube. https://youtu.be/SYXgMobMU8U?t=14

One-Minute Preceptor (Microskills Model):

The one-minute preceptor, or microskills model, outlines five basic steps to clinical teaching.  Below is a short summary of the five steps to Neher, Gordon, Meyer, and Stevens (1992) microskills model:

  1. Get commitment & set goals
  2. Probe for reasoning – “what” and “why” questions
  3. Teach 1-2 general rules/pearls
  4. Highlight the positives & be specific
  5. Fix mistakes – use nonjudgmental language and leave with a plan


This 4-minute video from Memorial University Office of Professional Development provides a summary of each step of the one-minute preceptor method.




Memorial University Office of Professional Development. (2017, May 11). The microskills model of clinical teaching (one minute preceptor). [Video]. Vimeo. https://vimeo.com/217050627

Neher, J. O., Gordon, K. C., Meyer, B., & Stevens, N. (1992). A five-step “microskills” model of clinical teaching. Journal of American Board of Family Practice, 5(4), 419-424. doi: 10.3122/jabfm.5.4.419

RIME Model

Another framework often used in clinical education for evaluation is the RIME model developed by Pangaro (1999):

  • Reporter
  • Interpreter
  • Manager
  • Educator


The Rhythm of RIME video from Matthew Eberly, MD, USUHS, Department of Pediatrics, provides an 11-minute overview of the RIME mnemonic, delivered by Dr. Louis Pangaro, and its use for evaluation of learners in the clinical setting.



Eberly, M. (2013, October 7). The rhythm of RIME. [Video]. Vimeo. https://vimeo.com/76308600

Pangaro, L. (1999). A new vocabulary and other innovations for improving descriptive in-training evaluations. Academic Medicine, 74(11), 1203-1207.

providing narrative feedback using rime language

Other Learner Feedback Models

Additional learner feedback models are outlined in short one-page primers found below.




Jennifer Lint
Email: jlint@neomed.edu

Curriculum Change Initiative

College of Medicine at NEOMED