Module 4: Constructive feedback

OBJECTIVES

  • Develop an understanding of the ways to deliver effective feedback
  • Determine what constitutes constructive versus destructive feedback

Feedback is the information given to a person about their performance which is used as the basis for improvement (2013, Oxford Dictionary). It is given in relation to the standard the job requires. It is an essential component of any learning environment. Constructive feedback is motivational and encourages continued learning and development. It provides information about behaviour and encourages the student to reflect upon practice. It identifies the strengths and areas for focus in the student and builds confidence in skill development. It provides direction and clarity of purpose.

Preparing for feedback:

When preparing to give feedback, all relevant information should be collected so that all the facts are available. The clinical supervisor / preceptor must be familiar with the standard that is required and the individual objectives to ensure that the learner is being assessed fairly. The clinical supervisor / preceptor should be properly prepared for the session including:

  • Identifying and minimising any personal bias or pre-conceived impressions
  • Predict the learners’ likely response
  • Contemplate possible solutions
  • Allow time to give feedback
  • Provide a private setting

Guidelines for giving feedback:

Feedback should be:

  • Selective
  • Specific
  • Timely
  • Descriptive
  • Sensitive
  • Creative.

Consider patient safety as a guideline in deciding when feedback is appropriate. For example, if a vital step has been missed during a procedure, ensure you intervene immediately by prompting the student to act:

“Andrew, when would be the time to perform your hand hygiene”.

When giving feedback, always maintain positivity throughout. As adult learners, it is essential that the student is given the opportunity to reflect upon their own performance and identify strengths and weaknesses themselves (See Achieving the Sound and Look of Leadership - PDF).

“So Andrew, how did you find that activity?.... What worked well for you?.... What would you do differently next time?”

With the appropriate insight, this allows the student to self-correct their practice with minimal intervention from the clinical supervisor / preceptor. The clinical supervisor / preceptor needs to select a few key areas to focus on during feedback to ensure the student is not overwhelmed. So although you may have found the whole performance to be sub-optimal, identify just a few things to concentrate on.

“I’m really pleased you identified communication as being something you could work on. I think if you approached the patient using different body language and tone, you would be able to connect with the patient and uncover so much more than you did today”.

Ask for clarification to ensure comprehension and ensure that you offer solutions. Never put off giving feedback to the end of the shift or next shift as it will lose its impact / effectiveness. Always ensure the student knows there are solutions and a pathway through their problems to ensure they remain positive and focussed. The Golden Rule of feedback: “if I have done well, reward me. If I have done badly, tell me but let me know I have the capacity to make it next time” (Hunt as quoted in Horner 1995).

ACTIVITY: Watch these short video clips below from “YOUTUBE” and reflect upon your learning. To activate, ‘right mouse clip’ on the hyperlink below and ‘click’ open.

YOUTUBE CLIP:   motivate others with feedback

Duration: 4.25 minutes

Management trainer Judi Clements shares some of the characteristics of effective motivation.

REFLECTIVE EXERCISE: Recall a situation where giving feedback to someone was not received well. Can you describe how this may have been done to achieve a different outcome?

YOUTUBE CLIP:   Assessment for learning- effective feedback

Duration: 5.07 minutes

A short video by Ian Garfield portraying a supervisor giving feedback to a student.

REFLECTIVE EXERCISE: How was the student guided to reflect upon her performance? How was this received by the student?

Performance counselling:

Performance counselling involves talking with a learner after ongoing feedback has been provided about issues relating to their performance or behaviour. It is a means of problem solving and working out alternative approaches that may assist the learner to improve performance. It is not a disciplinary procedure and should not be confused as such.

There are 3 phases of performance counselling:

  1. Preparation: Gather all facts and any evidence. Consider how the person will react and think of possible rebuttals and responses they may offer and then provide possible solutions to these. Ensure you have identified any personal bias that may cloud your judgement.
  2. Interview: Ensure that interruptions are minimised for the duration of the interview. Allow the learner to describe what went well and why? What was challenging and why? What they might do differently next time? Help them to establish the learning / knowledge gap and the possible causative factors. Help the learner make the necessary links to previous lessons learnt and identify possible solutions that may help the situation. Document them clearly and objectively.
  3. Follow-up: Ensure you arrange to meet with the learner again to establish the effectiveness of your plan.

Common counselling errors include:

  • Not clearly defining the behaviour required
  • Neglecting to provide regular or effective feedback to staff
  • Delaying performance counselling
  • Lack of preparation
  • Not having control of the interview
  • Being aggressive or compliant rather than assertive
  • Not allowing the learner to talk
  • Failing to actively listen
  • Not establishing the cause of the problem
  • Not setting an agreed plan of action.

The take home message for the delivery of constructive feedback is:

Remember to assume an empathetic approach to your role. Give regular constructive feedback and be clear in your language.