How to Give High Quality Feedback Greg Simons Associate GP Dean - - PowerPoint PPT Presentation

How to Give High Quality Feedback

Greg Simons

Associate GP Dean Oxford PGMDE 14 November 2012

Overview of Presentation

Why Feedback Timing Technique Work through scenario If time allows… Pitfalls

Feedback

Information about performance or behaviour that leads to action to affirm or develop that performance or behaviour.

Why is feedback important?

Identify current strengths and

weaknesses

Identify future learning and

development needs

Helps develop capacity to critically

evaluate own and others’ performance

Motivational Feedback

“the difference between a lady and a flower girl is not how she behaves, but how she's treated. I shall always be a flower girl to Professor Higgins, …but I know I can be a lady to you because you always treat me as a lady.”

The Pygmalion effect

Factors that affect motivation in tasks

• Clear about what is expected
• Supported by managers or supervisors
• Recognised for their efforts
• Contributing in a way which is positive and

recognisable

• Free to express their views and ideas
• Challenged in a way which helps them to

develop and be more creative

Good Feedback

• Specific
• Timely
• Balanced
• Based on observed facts
• Non-judgemental
• Promotes reflection
• Results in an action plan

(Norcini and Burch 2007)

Specific Timely Balanced Based on observed

facts Non-Judgemental Promotes reflection Results in Action plan

avoid personal comments

• BAD: “you fool! Can’t you remember that I needed these accounts for the meeting yesterday?”
• GOOD: “Shirley, I need the accounts for 2pm on Friday for the management meeting later in the

afternoon.” avoid mixed messages

• BAD: “John, you always look as if you have just got out of bed (but your work is good on the whole)
• GOOD: “John, I would like you to take more care with your appearance in order to make a better

impression” avoid diffusion

• BAD: “Some of you are not achieving your performance goals. You have to improve.”
• GOOD: “Richard, you have not achieved your performance goals this week. Can we talk about it &

work out some plans to improve?”

Specific Timely Balanced Based on observed facts Non-Judgemental Promotes reflection Results in Action Plan

say it while it's fresh; don't wait until a long time after the event.

Specific Timely Balanced Based on observed facts Non-Judgemental Promotes reflection Results in Action plan

All feedback is positive in that it is

designed to aid learning.

Avoid that ‘BUT’!! ‘and..’ works better

Specific Timely Balanced

Based on observed facts Non-Judgemental

Promotes reflection Results in Action plan

i.e. concrete examples; based on behaviour not personality

BAD: "I think you’re selfish in that you don’t listen to anyone

else".

GOOD: "I notice that you don’t look at people when they are

talking to you".

Specific Timely Balanced Based on observed facts

Non-Judgemental Promotes reflection Results

in Action plan

Specific Timely Balanced Based on

• bserved facts Non-Judgemental

Promotes reflection Results in Action plan

Ask for the trainees take on the evidence;

what he or she could do to improve

Overtly let them know you support them.

Motivational feedback before formative .

Specific Timely Balanced Based on observed facts Non-Judgemental Promotes reflection

Results in Action plan

Prioritise your feedback - don't overload the receiver Summarise what the learner has identified as action to be

taken

Encourage; get them to focus on positive outcomes and

therefore, a much easier and better future.

Time for a Task

Using the principles of good feedback discuss in groups

• f three how you would go about giving this young

Doctor some feedback? (10 Mins)

Be prepared to explain your solution to the group.

Scenario

You have a young female FY1 just allocated to your

service and meet her for the first time on your ward. You notice she is wearing a very short skirt and a revealing top both of which are entirely inappropriate. How would you give her feedback?

Scenario

You have had a written complaint from a patient about

your registrar’s attitude. The patient found him rude and arrogant. You have also has some informal feedback from the nursing staff which is similar. He is

• therwise a very capable clinician, ambitious and
• dedicated. How would you give this feedback?

Scenario

You are the Clinical supervisor of a female SHO. You

have become aware she has developed a relationship with another SHO from another service working in a different part of the hospital. You have received some complaints from the nursing staff that she has been seen passionately embracing the other SHO in a side room on your ward just prior to your ward round.

Good Feedback

• Specific
• Timely
• Balanced
• Based on observed facts
• Non-judgemental
• Promotes reflection
• Results in an action plan

(Norcini and Burch 2007)

Skills of effective feedback

— Generic communication skills; LISTEN and ASK. We have two

ears and one mouth!

— Try to make the trainee think! — Balance of challenge and support

Daloz’s Support-Challenge Grid

[ Daloz LA. Effective Teaching and mentorship: realizing the transformational power of adult learning experiences

• Fransisco. CA. Jossey-Bass, 1986 ]

Trainee withdraws from monitoring relationships No Growth possible

Trainee is not encouraged to consider or reflect on knowledge and images

Trainee grows through development of new knowledge and images Trainee becomes confirmed in pre-existing images and ideas

High Challenge Low Challenge No Support Full Support

Defensive positions to avoid King; BMJ 1999; 318 : S2-7200

Obligation Moral high ground Burying and fudging Minimising Colluding

Another Task if there is time

There have been several complaints from the nursing

staff about the poor personal hygiene of your latest Registrar- particularly his body odour! How would you give him this feedback?