Feedback – We Can’t Learn Without It

A simple feedback loop, applied in school zones in a small Californian suburb, “cut fatal injuries by about half.” (WIRED) By revealing speeding drivers’ speed to them via a giant on-street speedometer, “drivers slowed an average of 14 percent.” This effectively unraveled decades of law-enforcement dogma by proving the superior efficacy of feedback loops over punitive police surveillance, the traditional approach. Modern education has been moving slowly in this direction, but perhaps it lacks some of the tools that would enable this kind of feedback.

So what are feedback loops, what makes them so powerful, and how can they be applied to what’s going on in education thesedays?

40 years ago, Stanford professor Albert Bandura demonstrated that giving individuals clear goals and, more importantly, a means to evaluate their progress in real time, hugely boosted the likelihood that they would complete their given task. Bandura’s work has been confirmed and extended across psychology, epidemiology, military strategy, environmental studies, corporate training, engineering, and economics. The science behind the self-correcting magic of feedback loops can be broken down to four steps:

  1. Collecting the data
  2. Processing the data so it resonates with the subject
  3. Assigning weight or consequence to the data
  4. Recalibration of action as informed by the data

To use a very simple example , think about a tennis or volleyball player making a serve. If she observes the ball plow into the net, her brain instantaneously:

  1. Collects the data that the serve was no good,
  2. Does so in a way that makes sense to the player,
  3. Tells the player that she lost a point, a consequence of the mistake,
  4. Tells the player that she must strike the ball with more elevation on the next serve.

Enough serves and the player will be a top-level server due to the countless calibrations and recalibrations in this feedback loop. Ten thousand hours and all that…

But how can this be applied to a clinical context? Feedback is key in two growing areas in the health professions. One involves better feedback on the effects of medications and the other is in clinical skills education and training.

Consider the medical innovation Vitality GlowCaps – ‘smart’ pill caps that glow brightly and begin to play melodies as the patient’s time to take their medication gets nearer. Research has revealed the frightening fact that only about half of patients follow their pill consumption instructions exactly, leading to countless unnecessary deaths, particularly for those with heart issues. GlowCaps found a spectacular way to solve this issue. As Wired Magazine puts it,

“After three months, adherence in the control group had declined to less than 50 percent, the same dismal rate observed in countless other studies. But patients using GlowCaps did remarkably better: More than 80 percent of them took their pills, a rate that lasted for the duration of the six-month study.”

Harnessing the most fundamental element in the psychology of learning, this simple feedback loop has implications that could save countless lives.

Feedback in Education

What about feedback in educational programs – what problems can it solve? Consider the growing shortage of health professionals in countries like Canada. This excerpt from a 2016 Globe and Mail article sums it up best:

“The sum of all the numbers is a tightening nursing labour market,” says Karima Velji, president of the Canadian Nurses Association (CNA), said in a statement. “Immediate action is needed to stave off the potentially long-lasting trend of a shrinking [registered nurse] work force and its consequences for population health.”

What’s causing the shortage in labor supply? One theory is that numerous adult learners are unable to commit enough time to traditional face-to-face classes due to economic and family pressures. To some extent, online courses can help, but these courses don’t give the student the practice they need to perform clinical skills.

Basically, online learners need feedback and even on-campus students could use a lot more practice and feedback.  The main roadblock to more and better feedback loops in clinical programs has historically been data collection. Clinical educators have had to be present to see students performing skills and to give them the briefest of verbal feedback. Now that we’re in an age of video anywhere, anytime with smartphones and YouTube, surely there’s a way to use video for practice and feedback in clinical education. is betting that asynchronous video for practice and feedback at precise moments on student videos will become indispensable for skills training at scale. Using learner-recorded video uploaded to the WeVu platform, face to face student-to-teacher time can decrease considerably, lowering costs, time commitments, and even the program’s environmental footprint. But students will get more practice and more feedback that sticks with the learner.  Online education with this kind of video-for-skills-learning may mobilize thousands of mature students unable to commit to a traditional schooling hours.

Feedback is really the central element of any skills learning program across many disciplines and professions. If technology can help us get more and better feedback, it will make a huge positive impact in our education systems. Fortunately, educators are now starting to see that video technology can contribute to the active, doing, part of education, not just the watching and listening part.