More on Feedback
Frame-based feedback takes into account the thought processes and perspective of the other person. The educator should take the time to inquire about why the other person chose to act as they did. In turn, the educator will gain insights into why things happened that can then be used to craft more helpful and effective feedback.
- Set context
- State concerns and behavior
iii. Ask for their view/why this is happening (elicit his/her frame)
Be open without barriers, ask what’s stopping them from changing
Ideal for critical feedback
The educator approaches the receiver in an open and supportive manner. However, the educator does not ever mention the receiver’s main problem; instead, the educator may ask multiple questions, hoping that the receive will identify or guess the problem himself/herself. Often, this approach does not work because most of the time, the receiver will not have the insight needed to identify the problem.
Solution: Clearly identify the problem; it is okay to judge the behavior, but not the person
Ideal for feedback at the end of a rotation to elicit open conversation
Giving positive feedback is just as important as giving negative feedback, but positive feedback should be distinguished from praise alone. By telling the trainee specifically what they did well, the train will know exactly what they did well, which reinforces learning.
Ideal for reinforcing specific behaviors
- Set clear expectations and rules
- Feedback should be timely so everyone can remember specific details but not so soon that it may lead to emotional responses
- Plan ahead to allow enough time for the feedback session
- Be cognizant of external factors (overnight call, long shifts)
- If possible, try to limit feedback to 3 to 5 main points, such that the feedback won’t be too overwhelming and limit the person’s ability to formulate change
- Limit feedback to behaviors that are remediable/correctable
- Share your reflections rather than give advice – feedback should only be given directly to the receiver from someone who directly observed the given behavior
- Focus on specifics and avoid generalizations
- Acknowledge the effort, not just the final results
- Learning is a process – recognize areas that will require continued or ongoing monitoring and exploration and set-up recurrent meeting times
- Meaningful feedback also challenges the receiver to be better by doing X and Y, therefore helping to facilitate positive change
- If you get stuck, then model a previous mentor who provided feedback to you
Adapted from the Society of General Internal Medicine
Feedback is aimed at an aspect of the supervisor’s behavior. Feedback is delivered in a non-threatening, collaborative manner in an attempt to solve problems that exist, and to propose potential solutions.
Highlights: State impact of the issue, use “I” rather than “you” statements
Debriefing a negative outcome can convert a difficult experience into a rich learning opportunity. Ask the learner to share their “frame” (how they understand the event and its cause). This approach can reveal the specific area that needs attention and the educator can then tailor the educational intervention to the learner.
- Make sure you are ready – receiving feedback requires maturity, self-awareness, and commitment to the goals of learning and improving
- Know your goals and share them – make learning goals for yourself and share them with your supervisor (senior resident, attending physician, etc.)
- Be active – seek out opportunities to receive feedback
- Request for specific examples that support a given feedback note and ask for clarification if necessary
- When giving yourself feedback, don’t be too hard on yourself
- If you are offered feedback during a time when you are rushed or stressed, then ask to reschedule
Adapted from the Society of General Internal Medicine
- Set a mutually available time to meet for formal feedback
- Open the conversation by having the recipient self-assess
- Brainstorm and decide on solutions collaboratively
- Follow-up and assess understanding/acceptance
- Separate behavior from personal qualities: Support recipient’s sense of self-worth, understand their vulnerabilities & strengths
- Be aware of your own biases of own feelings and assumptions and manage them appropriately
- Use descriptive, non-judgmental language
- Think of yourself as a coach or facilitator, rather than as a judge
Adapted from John Hopkins Medicine
Responses to feedback from Senior Breakfast
The following are some common concerns raised during Senior Breakfast regarding giving feedback with responses on how to deal with these problems. Understand that giving feedback is a process in itself, meaning that you can only get better and become more comfortable through continued practice.
“I struggle with giving feedback; I want to remain cool with my colleagues while providing critical feedback at the same time.”
It is possible to remain “cool” with your colleagues while providing critical feedback simultaneously! Understand that the feedback process should be objective to simply state observations and facts while providing solutions for growth. To lessen any tension or stress, preface the meeting by stating the purpose—that is, that you want to see your colleague succeed and strengthen in certain areas of professional growth. In addition, using non-judgmental and open language will invite the learner to engage with you more readily.
“When interacting with colleagues on a similar level, I find difficulty giving feedback when our styles are completely opposite.”
Giving feedback to peers can certainly be challenging, especially when considering that everyone learns in a different way. If you find a concerning behavior, then you should ask to set a time and place to speak with your colleague privately. Though your styles may be opposite, a frame-based feedback style may be helpful, by which you set the context of the behavior, state your concerns, and then ask for their thoughts or perspective. Doing so will allow you to better understand their mindset during the event and prepare you in coming up with a solution together that complements their style of practice.
“I am a little scared about providing feedback to a senior resident or attending because they may be too busy. Unless they specifically ask for feedback, then I won’t offer it.”
Providing feedback to those above you can seem challenging, or perhaps even intimidating, but it is necessary when concerning events or behaviors arise. In order to do what’s best for the patient, make sure to reach out to the colleague or attending privately and ask to go over the event. Make sure to use “I” statements rather than “you” statements in order to not come across as blaming or accusatory. State your observations clearly and provide an explanation for why the event was concerning to you. It may be helpful to state that you are reaching out to provide feedback because you were concerned for the patient.
