Beyond the handoff

‘Forward feeding’ is a process used to address skills or behaviours requiring improvement but not warranting a professional standards committee review. This process allows for ongoing coaching beyond a single clerkship block. Similar to a patient handoff, forward feeding ensures continuity in guiding students with professionalism or clinical skill challenges. However, fairness remains a key concern—how can information be shared without unintentionally biasing the next educator's perspective? Effective monitoring and coaching requires a longitudinal communication system with safeguards.1 A structured, competency-based approach ensures feedback is specific, actionable and fair, fostering development without influencing evaluations.1 From 2020 to 2024, we piloted a ‘Feed Forward’ process during the clerkship phase across three clinical campuses, involving 21 clerkship directors (CDs). At the conclusion of each block, CDs could identify areas for coaching tied to specific learning objective. The CDs provided information for the subsequent CD through our evaluation system, which was transmitted by the director of assessment, to create a mutually agreed upon improvement plan for coaching with the student. Students are required to participate in this process and received written narratives from CDs at the block's conclusion, detailing whether all objectives, including those highlighted in the feed forward, were met—closing the ‘forward feeding’ loop. To date, the process has supported collaboration among CDs and 74 students to develop performance plans. Success relies on a defined framework specifying when and how information is relayed, ensuring consistency, transparency and alignment between CDs and students.1 While most students improve, some rare cases require escalation, including formal narrative comments reviewed by the professional standards committee, which may implement stricter action and improvement plans. Challenges have arisen when feedforward occurs late in the academic year, just before transition to the final year. Individualized schedules require the assessment director to determine the student's next clinical experience, coordinate with the rotation director, and develop an improvement plan. Though uncommon, these cases have informed efforts to help CDs identify skill deficits earlier and bridging the clerkship and final-year curriculum more effectively. Faculty development is critical for success. Ongoing feedback loops allow CDs to refine their approach, while workshops, meetings and collaborative projects promote a culture of continuous improvement and share expertise. Forward feeding must remain formative, providing early intervention to build skills before deficits lead to adverse outcomes. Identifying and addressing threats to competency achievement ensures students receive the support they need to succeed. Forward feeding offers a practical, transferable method for integrating longitudinal coaching into evaluation systems. By addressing professionalism and clinical skills gaps, forward feeding fosters opportunities for formative feedback, collaborative improvement planning and alignment with clinical learning objectives, ultimately to upskill the student. Anna Lama: Conceptualization; data curation; writing – original draft. Jason Hedrick: Conceptualization; writing – review and editing; resources. The authors have no conflicts of interest. The WVU Office of Human Resource has determined this work to be a Not Human Subjects Research (NHSR)/Flex Protocol (2405981058) type. The data that support the findings of this study are available from the corresponding author upon reasonable request

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