Back to Basics with the Plus/Delta During COVID-19
MedEdPearls May 2020: As educators, we must remember to go “back to basics” in times of uncertainty or when we experience new teaching and learning challenges. Have you tried the Plus/Delta as part of in-person or online teaching and learning in medical and health professions education?
As educators, we must remember to go “back to basics,” in times of uncertainty or when we experience new teaching and learning challenges. Adult learners desire to give and receive feedback about their learning experiences. Educators navigating the transition to online teaching and learning can utilize this in their favor. Although varied methods can be utilized, one simple, efficient, translatable, and free way to do so is to implement the “Plus/Delta Debriefing Model” (Plus/Delta) as part of routine educational quality improvement.
The aim of the Plus/Delta is to quickly generate useful feedback by asking learners to identify what specifically went well with the educational session and what specifically could be improved for next time. These data are collected by the educator immediately following the session via online survey link for individual feedback or a shared virtual document for crowdsourced feedback. When collected anonymously, this allows learners a safe method to offer constructive feedback which they might not otherwise feel comfortable sharing.
Educators who implement this model must commit to being receptive to learner feedback and embrace both a growth mindset and a goal for continuous educational improvement. This includes sharing the aggregated, anonymized feedback with learners, making iterative changes to course design when possible, and being transparent with learners when changes cannot be made. A secondary benefit of the Plus/Delta is that it aligns with the “learner’s need to know” adult learning theory principle and ensures that learners have some sense of partnership in their learning. Additionally, as educators are adjusting instruction methods, consider how you can meaningfully share what you learned through the Plus/Delta with your colleagues.
Have you tried the Plus/Delta as part of in-person or online teaching and learning? Share your experiences on Twitter using #MedEdPearls!
About the MedEdPearls Author
The MedEdPearls are a collaborative, peer-reviewed, monthly brief intended to provide practical tips and strategies for medical and health professions educators to enhance teaching and learning.

Kristina Dzara
PhD, MMSc
- Associate Professor of Family and Community Medicine
- Assistant Dean for Scholarly Teaching and Learning
- Director of the Center for Educator Development, Advancement, and Research, Saint Louis University School of Medicine
- Jean Bailey, PhD – Virginia Commonwealth University School of Medicine
- Carrie Bowler, EdD, MS, MLSCM (ASCP) – Mayo Clinic School of Continuous Professional Development
- Kristina Dzara, PhD, MMSc (Educators ’16; Assessment ’16; HCE 2.0 ’17) – Saint Louis University School of Medicine
- Shanu Gupta, MD, SFHM – University of South Florida Morsani College of Medicine and Tampa General Hospital
- Jennifer Hillyer, PhD – Northeast Ohio Medical University
- Larry Hurtubise, PhD, MA (HCE 2.0 '16) – The Ohio State University
- Anna Lama, EdD, MA – West Virginia University School of Medicine
- Machelle Linsenmeyer, EdD, NAOME (Assessment ’07) – West Virginia School of Osteopathic Medicine
- Skye McKennon, PharmD, BCPS, ACSM-GEI – Washington State University Elson S. Floyd College of Medicine
- Rachel Moquin, EdD, MA – Washington University School of Medicine
- Stacey Pylman, PhD – Michigan State University College of Human Medicine
- Leah Sheridan, PhD – Northeast Ohio Medical University
- Lonika Sood, MBBS, MHPE – Washington State University Elson S. Floyd College of Medicine
- Mark Terrell, EdD – Lake Erie College of Osteopathic Medicine
- Stacey Wahl, PhD – Virginia Commonwealth University School of Medicine
Harvard Macy Institute
Harvard Macy Institute
The Harvard Macy Institute educates, connects, and serves health care leaders around the globe by providing advanced faculty development programs, thought leadership, and impactful networking opportunities.
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