Your manager sidles up to you and says “Lynne, can you make an appointment to come and see me, please? I need to give you some feedback.”
What is your immediate, gut reaction? Oh dear; a feeling of dread; “what have I done wrong?”; “what is she going to tell me?”; “should I bring a support person?”; “everybody probably knows…whatever it is … and I don’t even know what it is!”
That word “need” is a giveaway, isn’t it? Sounds like the boss is dreading it as much as I am.
If you google ‘feedback’ you will find this quote popping up all over the place: “Feedback is a gift”, but for many of us the feedback we receive feels more like a poison chalice than a ribbon-wrapped present.
Giving and receiving feedback
Recently I was talking with a group of senior health leaders and managers, and we discussed the challenge of giving good feedback. We acknowledged its importance for ourselves and those we manage, but agreed how difficult it could be to both give and receive. So what does good feedback look like?
How do we provide effective feedback to those we have been given the privilege of managing, to those colleagues whom we want to encourage? How do we want to be given feedback to improve ourselves?
The first thing about feedback is that the person you are giving it to needs to know that it is feedback. So often when we use the word ‘feedback’, what follows are criticisms or negative remarks, whereas when we provide positive feedback, it’s a smile, a “great job”, a pat on the back, and the person may not even realise that you just gave them feedback. The “great job” feedback may also be vague and probably not the most helpful format, as we will discuss later.
The second thing about feedback is that if we don’t receive feedback very often ourselves, and we don’t give it often enough, then when we need to raise an issue or concern in feedback, it can come like a bolt out of the blue. This can result in the potential for the shock, fear and dread reaction described earlier.
Practice makes better
We need to provide feedback regularly for two good reasons. One is that those receiving the feedback from you, those you are supervising or mana
ging, have the opportunity of getting lots and lots of your feedback, most of it positive, encouraging and not at all negative. So when you need to say something that is more challenging, it will come with a relationship and an experience of feedback that they know to be in their best interests.
The second reason is, the more you practise giving feedback, the better you will become. It is a critical communication skill and like any other form of communication, practise makes better.
How, where and why to give feedback
The characteristics of effective feedback are that it is brief and focussed, highlights the next step for success and is more observational (what I noticed) than interpretational (what I think).
If the person has asked you for feedback, or is expecting it, then giving feedback begins with self-assessment. “How do you think you went with that? What did you learn? What are you going to do differently next time?”
Health professionals are generally highly self-aware and have a tendency towards self-criticism, so if there are deficiencies to be pointed out, it may well be that the person is already fully aware of them. What they need then, is to be pointed towards the next step for success.
If you are offering feedback, begin by asking permission. “May I give you some feedback?” and only proceed if the answer is yes. If they aren’t ready to hear it, and there may be a really good reason, they won’t benefit from it. At least, not right then.
When you are giving feedback, generally you will be in an ongoing professional relationship with this person, as a line manager, professional supervisor or colleague. If that’s the case there will be many, many opportunities for you to provide feedback to that person, and the majority of the feedback you give should be positive. By majority, I mean 80 to 90 percent.
Then, when we need to provide some feedback about a less positive aspect of their performance, the feedback conversation won’t come as a shock and they will recognise, by placing this in the context of all the positive and encouraging feedback that came before and they know they can expect afterwards, that this feedback is also intended to be for their benefit and is given with their best interests in mind.
Reinforcing positive behaviour
Positive feedback (the kind I am encouraging you to give lots of) doesn’t need to be only recognition of great work that goes above and beyond. There is enormous benefit in providing positive feedback for just doing the job well. For example, thanking someone for turning up on time for meetings can reinforce the behaviour yo
u want to see, and they know you are noticing. Your team members will know that you appreciate their efforts, and positive behaviours will be reinforced.
Those of you who have attended a parenting course when your children were young will recognise that this is “catching your child being good” to offer praise and encouragement, which reinforces the desired behaviour so it will happen more often. The paediatrician in me can’t help mentioning this. Positive feedback makes a behaviour increase and ignoring a behaviour will tend to extinguish it. That’s why noticing and providing feedback on the good stuff is so important.
A simple feedback model
- Ask the person if you can give them some feedback
- Tell them what they did – what you observed – in objective, behavioural, descriptive terms
- Let them know the impact of that performance or behaviour, how it helped you or made a difference to the team. Use “I” statements
- Say “thank you, or well done” (if it is positive behaviour).
Here’s an example:
“Stephen, can I give you some feedback? When you put a meaningful title into the subject line of an email, like the one you sent me this morning, it really helps me to prioritise my workload. Thanks for that, and please keep on writing your emails to me that way.”
If the feedback is about what you would like to see changed, then the last part of the recipe is “Are you able to change that?”, or “Can you work on that please?” Preferably offering some detailed but limited ideas about the next step for them in order to improve.
The feedback sandwich
A word of warning about the feedback sandwich.
I suggest you avoid the good-bad-good “feedback sandwich”, where some honest, perhaps challenging performance feedback is given between two pieces of positive feedback or praise.
It looks just like what it is – an attempt to soften the blow, and can look inauthentic. The risk is that the “great job” bread of the sandwich disguises the meat, so they don’t hear what you really need to tell them. Alternatively, the next time you attempt to offer some positive feedback (which we have seen is so important), they will run a mile.
I wish I had learned about the power of feedback, back when I was starting out as a clinician manager, but it’s not too late for me, nor for any of us, to actively seek feedback and to practice giving feedback.
Feedback may be a gift, but I prefer to think of it as fertilizer, that helps us to grow to become better versions of ourselves. In my next article on feedback, I will argue why praise is not the best way to encourage high performance.
There are some great podcasts that further explore these ideas about feedback.
Written by Dr Lynne McKinlay, Senior Medical Educator
Read more about Dr McKinlay.
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