Negative feedback in graduate medical education: perspectives from self-determination theory

Both positive and negative feedback play important roles in the personal and professional development of medical trainees. While positive feedback is often considered easier to provide, limited information exists on how to best administer and receive constructive (or "negative") feedback to foster clinical growth. Self-determination theory is a psychological framework that describes how various factors (e.g., relatedness, autonomy, and competency) affect one's intrinsic and extrinsic motivation. We posit that approaching feedback through the lens of self-determination theory, with a particular focus on balancing trainee autonomy with maintaining professional relationships, can provide valuable guidance for enhancing both the delivery and reception of negative feedback in graduate medical education.