Evidence-Informed Facilitated Feedback: The R2C2 Feedback Model

Publication ID Published Volume
10387 April 29, 2016 12

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R2C2 is an evidence-based reflective model for providing assessment feedback. It includes four phases: (1) relationship building, (2) exploring reactions to the feedback, (3) exploring understanding of feedback content, and (4) coaching for performance change. It provides a strategy for facilitating feedback conversations that promote engagement with performance data and enable coaching for improvement. While feedback continues to pose challenges, new understanding is emerging. Feedback is now being seen as an interaction in which learner engagement, supportive relationships, reflection, and cooperative planning are important. In response and through research, we developed and tested the R2C2 model and teaching materials to support its use. The package of educational materials includes paper-based and video resources designed to support interactive learning and skills development in facilitating feedback and coaching. Specific strategies are described and demonstrated for each phase of the R2C2 model and include a learning change template for the coaching phase. Resources can be used by an individual or group. A workshop outline with presentation slides and a practice scenario are also included. Through research, invited and peer-reviewed presentations, and feedback from colleagues who have used the materials and the R2C2 model, we have learned that the model is intuitive and easy to use, that it can engage the learner and support coaching, and that the educational materials are clear and useful. The R2C2 feedback model appears to be helpful for engaging learners in their feedback and their using it for planning for improvement.


Sargeant J, Armson H, Driessen E, et al. Evidence-informed facilitated feedback: the R2C2 feedback model. MedEdPORTAL Publications. 2016;12:10387. http://doi.org/10.15766/mep_2374-8265.10387

Educational Objectives

By using the R2C2 model, supervisors will be able to:

  1. Develop a relationship and rapport with residents.
  2. Explore residents’ reactions to their feedback and promote their acceptance of feedback and assimilation with their own self-assessment, especially when the feedback is disconfirming.
  3. Assist residents in understanding both the content of their feedback and the standards or milestones against which they are being measured.
  4. Coach residents in identifying performance gaps, setting learning and improvement goals, developing and implementing realistic plans to address these, and assessing the plans.


  • Feedback, Coaching, Assessment, Competency-Based Medical Education, CBME, Improvement, Evidence-Based, Learning/Change Plan, Milestones


  1. Driessen E, Scheele F. What is wrong with assessment in postgraduate training? Lessons from clinical practice and educational research. Med Teach. 2013;35(7):569-574. http://dx.doi.org/10.3109/0142159X.2013.798403
  2. Iobst WF, Sherbino J, ten Cate O, et al. Competency-based medical education in postgraduate medical education. Med Teach. 2010;32(8):651-656. http://dx.doi.org/10.3109/0142159X.2010.500709
  3. Miller A, Archer J. Impact of workplace based assessment on doctors’ education and performance: a systematic review. BMJ. 2010;341(7775):c5064. http://dx.doi.org/10.1136/bmj.c5064
  4. Pangara L, ten Cate O. Frameworks for learner assessment in medicine: AMEE Guide No. 78. Med Teach. 2013;35(6):e1197-e1210. http://dx.doi.org/10.3109/0142159X.2013.788789
  5. Sargeant J. Facilitated reflective feedback for coaching and change. Canadian Association for Medical Education Web site. http://www.came-acem.ca/docs/came-voice-voix/CAME-Voice-Voix-Feb-11-2015-EN.pdf. Published February 11, 2015.
  6. Sargeant J, Armson H, Chesluk B, et al. The processes and dimensions of informed self-assessment: a conceptual model. Acad Med. 2010;85(7):1212-1220. http://dx.doi.org/10.1097/ACM.0b013e3181d85a4e
  7. Sargeant J, Lockyer J, Mann K, et al. Facilitated reflective performance feedback: developing an evidence- and theory-based model that builds relationship, explores reaction and content, and coaches for performance change (R2C2). Acad Med. 2015;90(12):1698-1706. http://dx.doi.org/10.1097/ACM.0000000000000809
  8. Sargeant JM, Mann KV, van der Vleuten CP, Metsemakers JF. Reflection: a link between receiving and using assessment feedback. Adv Health Sci Educ Theory Pract. 2009;14(3):399-410. http://dx.doi.org/10.1007/s10459-008-9124-4

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ISSN 2374-8265