THE DO’S AND DON’TS THE DO’S AND DON’TS OF GIVING EFFECTIVE FEEDBACK OF GIVING EFFECTIVE FEEDBACK

TO COLLEAGUESTO COLLEAGUES

January 24, 2012January 24, 2012

Department of MedicineDepartment of Medicine

OBJECTIVESOBJECTIVES

►To identify both the opportunities and To identify both the opportunities and challenges in giving effective feedback challenges in giving effective feedback to colleaguesto colleagues

►To describe key elements of To describe key elements of constructive feedbackconstructive feedback

►To consider the consequences of poor To consider the consequences of poor quality or absent feedbackquality or absent feedback

CASE VIGNETTE #1CASE VIGNETTE #1You will be meeting Dr. Enthused, a junior faculty member. You will be meeting Dr. Enthused, a junior faculty member.

He is somewhat apprehensive about this meeting as it He is somewhat apprehensive about this meeting as it will be the first time he is meeting with you to review his will be the first time he is meeting with you to review his performance since he was recruited four years ago. Dr. performance since he was recruited four years ago. Dr. Enthused spends most of his time doing clinical work Enthused spends most of his time doing clinical work

and clinical teaching at the hospital. He is not and clinical teaching at the hospital. He is not particularly interested in research or other scholarly particularly interested in research or other scholarly

endeavors. His teaching evaluations are excellent. Dr. endeavors. His teaching evaluations are excellent. Dr. Enthused has not volunteered for any committees Enthused has not volunteered for any committees

because he is so busy with his clinical and teaching load. because he is so busy with his clinical and teaching load.

HOW WOULD YOU APPROACH GIVING HOW WOULD YOU APPROACH GIVING

FEEDBACK TO DR. ENTHUSED?FEEDBACK TO DR. ENTHUSED?

CASE VIGNETTE #2CASE VIGNETTE #2

You will be meeting with Dr. Longtime for her annual You will be meeting with Dr. Longtime for her annual performance review. She is a successful clinician-scientist performance review. She is a successful clinician-scientist

and is responsible for a busy lab. She has won several and is responsible for a busy lab. She has won several national research awards. She does some teaching in the national research awards. She does some teaching in the

Basis of Medicine component of the curriculum, some clinical Basis of Medicine component of the curriculum, some clinical teaching on the ward (with residents) as well as supervision teaching on the ward (with residents) as well as supervision of graduate students in her research lab. Medical students of graduate students in her research lab. Medical students

and residents evaluate her teaching as below average saying and residents evaluate her teaching as below average saying that she appears unprepared for her lectures and does little that she appears unprepared for her lectures and does little

bedside teaching on the ward. bedside teaching on the ward.

HOW WOULD YOU APPROACH GIVING HOW WOULD YOU APPROACH GIVING

FEEDBACK TO DR. LONGTIME?FEEDBACK TO DR. LONGTIME?

QUESTIONSQUESTIONS

►What is the What is the rolerole of feedback in the of feedback in the annual performance review?annual performance review?

►What characterizes What characterizes effectiveeffective feedback feedback in this context?in this context?

►How can we How can we improveimprove the giving of the giving of feedback to our colleagues?feedback to our colleagues?

Feedback: Return of a signal through an electronic circuit causing a high-pitched

screeching noise

FEEDBACK

►Communication to another person which gives information about how he/she affects and is perceived by others.

►A way of helping another person consider changing his/her behavior.

Feedback should be given in a wayFeedback should be given in a way

that the receiver can that the receiver can hearhear it, it,

understandunderstand it, and it, and choosechoose

to use or not use it.to use or not use it.

ARE WE DIFFERENT FROM OUR ARE WE DIFFERENT FROM OUR STUDENTS?STUDENTS?Feedback is...Feedback is...► Part of the learning Part of the learning

processprocess► Based on learning Based on learning

objectives objectives ► Appropriate Appropriate

learning learning environment & environment & opportunitiesopportunities

►ObjectiveObjective► TimelyTimely

► Part of the academic Part of the academic and career and career developmental developmental processprocess

► Based on clear Based on clear expectationsexpectations

► Appropriate academic Appropriate academic environment and environment and opportunitiesopportunities

► ObjectiveObjective► TimelyTimely

ARE WE DIFFERENT FROM OUR ARE WE DIFFERENT FROM OUR STUDENTS?STUDENTS?Feedback is...Feedback is...► Valued by the learnerValued by the learner► Positive & reinforcing Positive & reinforcing

feedback is easy to give feedback is easy to give (and receive)(and receive)

► Corrective and Corrective and constructive feedback is constructive feedback is harder to give (and harder to give (and receive)receive)

► Continuum between Continuum between formative and summativeformative and summative

► Due process is importantDue process is important

► Valued by facultyValued by faculty► Positive & reinforcing Positive & reinforcing

feedback is easy to give feedback is easy to give (and receive)(and receive)

► Corrective and Corrective and constructive feedback is constructive feedback is harder to give (and harder to give (and receive)receive)

► Continuum between Continuum between formative and summativeformative and summative

► Due process is importantDue process is important

OPPORTUNITIESOPPORTUNITIES

►To express appreciationTo express appreciation►To encourage dialogueTo encourage dialogue►To share informationTo share information►To guide reflectionTo guide reflection►To clarify expectationsTo clarify expectations

OPPORTUNITIESOPPORTUNITIES

►To adviseTo advise►To explore new directionsTo explore new directions►To mentorTo mentor►To identify emerging leadersTo identify emerging leaders►To promote excellenceTo promote excellence►To jointly plan for the upcoming yearTo jointly plan for the upcoming year

CHALLENGES

►Fear of damaging the relationship►Awkward to communicate►Confrontational►Nothing will change►Assumption that faculty members

instinctively know their strengths and weaknesses

►Past difficult experiences

THE COST OF AVOIDANCETHE COST OF AVOIDANCE

►Failure to reinforce desired performanceFailure to reinforce desired performance►Suboptimal performance unchangedSuboptimal performance unchanged►Confirms faculty assumptions that all is Confirms faculty assumptions that all is

finefine►Failure to meet faculty members’ needsFailure to meet faculty members’ needs► Impact on role modeling and Impact on role modeling and

departmental culturedepartmental culture►Consequences on accreditationConsequences on accreditation►Longterm effect on departmental successLongterm effect on departmental success

Failure to fulfill our role as Failure to fulfill our role as LEADERLEADER

EFFECTIVE FEEDBACK: EFFECTIVE FEEDBACK: GENERAL GUIDELINESGENERAL GUIDELINES

►Should be viewed as a “normal” component of faculty life: expected and routine

►Performance criteria should be clear►Specific behaviors and aspects of performance►Non judgmental language (Use “I” statements)► Limited in quantity►Bi-directional dialogue rather than Chair/Chief-

led transmission of information only► Includes plans for future change

THE CAIRN MODEL OF THE CAIRN MODEL OF CONSTRUCTIVE FEEDBACKCONSTRUCTIVE FEEDBACK

►Context (Individualized)Context (Individualized)►Action (Performance)Action (Performance)► Impact (Positive or negative)Impact (Positive or negative)►Review (Common understanding)Review (Common understanding)►Next steps (Action Plan)Next steps (Action Plan)

T. De la RosaT. De la Rosa

THE PENDLETON MODEL: REFLECTIVE FEEDBACK

CONVERSATION1. The faculty states what is good about

his or her performance2. The chair/chief states areas of

agreement and elaborates on good performance

3. The faculty states what area of performance could be improved

4. The chair/chief states what he/she thinks could be improved

EFFECTIVE FEEDBACK: EFFECTIVE FEEDBACK: SPECIFIC GUIDELINESSPECIFIC GUIDELINES

►Related to goals defined in earlier Related to goals defined in earlier meetingsmeetings

►Clear and explicit expectationsClear and explicit expectations►Based on objective dataBased on objective data►Aligned with departmental visionAligned with departmental vision►Positive feedback includedPositive feedback included►Expectations defined together for the Expectations defined together for the

upcoming yearupcoming year►Don’t make it personal!Don’t make it personal!

DON’TSDON’TS

►Don’t Don’t imposeimpose your views your views►Don’t focus Don’t focus onlyonly on problems on problems►Don’t focus on Don’t focus on personalitypersonality issues issues►Don’t include Don’t include sarcasmsarcasm or or angeranger►Don’t Don’t avoidavoid the difficult situations the difficult situations►Don’t give Don’t give mixed messagesmixed messages (but...) (but...)►Don’t give a long rambling Don’t give a long rambling monlogue!monlogue!

DO’SDO’S

► Plan aheadPlan ahead► Come preparedCome prepared► Ensure your colleague comes preparedEnsure your colleague comes prepared► Use objective informationUse objective information► Be specificBe specific► Be timely and regularBe timely and regular► Commit to regulated honesty Commit to regulated honesty ► Accept to receive feedbackAccept to receive feedback

DO’SDO’S

► Ensure privacyEnsure privacy► Take the necessary timeTake the necessary time►Do a lot of listening (80-20)Do a lot of listening (80-20)►Develop future goals and plans collaborativelyDevelop future goals and plans collaboratively► Be concrete and specificBe concrete and specific► Ensure expectations are clear and understoodEnsure expectations are clear and understood► Value and reinforce the relationshipValue and reinforce the relationship►Document the processDocument the process

CONCLUSIONCONCLUSION

“The trouble withopportunity is that italways comes

disguisedas hard work” Anonymous