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Item Overcoming Barriers to Providing Narrative Feedback in Pre-clinical Medical Education: Design and Implementation of a Comment Builder Tool(2023-04-28) Hoffman, Leslie A.; Shere, Helen; Bauer, Erich; Vargo-Gogola, TracyFormative feedback is an essential component of competency based medical education1. This feedback should be individualized, reinforce effective behaviors, and provide actionable strategies for improvement. In the first year Human Structure course at Indiana University School of Medicine (IUSM), students complete a two-part assignment to assess the Practice-Based Learning and Improvement competency. Faculty are expected to provide narrative feedback to students on the assignment; however, narrative feedback was not consistently provided to all students in prior years. To lower the barriers to providing feedback, a narrative comment builder tool was developed and implemented. Here we report our experiences with developing and implementing the tool and evaluating ongoing barriers to providing narrative feedback to students.