Feedback sandwiches affect perceptions but not performance.

The feedback sandwich technique-make positive comments; provide critique; end with positive comments-is commonly recommended to feedback givers despite scant evidence of its efficacy. These two studies (N = 20; N = 350) of written peer feedback with third-year medical students on clinical patient note-writing assignments indicate that students think feedback sandwiches positively impact subsequent performance when there is no evidence that they do. The effort necessary to produce feedback sandwiches and students' unwarranted confidence in their performance impact have implications for teaching about how to give feedback.