Providing feedback to trainees in clinical settings is considered important for development and acquisition of skill. Despite recommendations how to provide feedback that have appeared in the literature, research shows that its effectiveness is often disappointing. To understand why receiving feedback is more difficult than it appears, this paper views the feedback process through the lens of Self-Determination Theory (SDT). SDT claims that the development and maintenance of intrinsic motivation, associated with effective learning, requires feelings of competence, autonomy and relatedness. These three psychological needs are not likely to be satisfied in most feedback procedures. It explains why feedback is often less effective than one would expect. Suggestions to convey feedback in ways that may preserve the trainee's autonomy are provided.