Feedback and Feedback Culture in Medical Education: Evolution, Evidence, and Emerging Horizons

Feedback is a key component of medical education and is essential for progression throughout medical training. While extensive literature describes best practices for delivering feedback, less is known about the critical role of feedback culture and its impact on feedback practices. This narrative review aims to discuss the evolution of feedback in medicine, the role of feedback culture and its impact on feedback practices, strategies to foster a positive feedback culture, and opportunities and challenges for feedback in the age of artificial intelligence. Relevant articles were identified through database searches and were selected based on relevance to the aims of this review. Our review demonstrates that the literature has shifted to emphasize the importance of broader sociocultural factors in shaping feedback and feedback interactions. Determinants of a positive feedback culture stem from all levels of feedback interactions, including individual learner’s engagement with feedback, interpersonal relationships and strong educational alliances, and institutional level factors that generate a positive culture. These determinants may then be translated into strategies to enhance and sustain a positive feedback culture. The advent of artificial intelligence in medical education has provided opportunities to enhance feedback, although the impact on feedback culture remains unknown. Future research must focus on effective strategies to measure feedback culture which must then be utilized to evaluate the impact of feedback culture on trainee and patient outcomes.