Giving effective performance feedback

Session objectives• Identify the uses of feedback

• Explore the methods of providing feedback to learners

• Explore the general principles of feedback

• Identify two models of giving effective feedback

• Identify two different types of assessment

• Discuss appraisal tools

Your experiences of feedback

• …an example of when feedback worked well…

• …an example of when feedback did not work well…

The two extremes…

• “Damaging feedback”Erosion of confidence – nothing

learnt

• “Vanishing feedback”Avoiding conflict – message lost

Feedback

The 10 general principles of giving effective feedback…

(applies to verbal & written)

1. Set the scene

• Place, time, supportive environment

• Feedback is more effective when it becomes routine

2. Be explicit• This is feedback

3. Be descriptive rather than evaluative

This reduces defensiveness“…You were really weak in getting

information from that patient…”VS

“…Did you notice that you avoided eye contact with the patient as you were taking that history…”

4. Focus on behavior not personality

Minimises a defensive response & allows opportunities for change

“…You weren’t really interested in getting information from that patient…”

VS“…Roughly how many open-ended

questions do you think you asked…”

5. Be specific rather than general

More likely to result in an improved performance

“…You’d better improve your skills…”VS

“…You picked up really well on the patient’s back pain but you seemed unsure about how to explore the problem…”

6. Involve sharing information rather than giving advice

“…This is everything you need to know when managing a patient with a drug overdose…”

VS“…Would you like to hear about my

first experiences of managing a drug affected patient…”

7. Be limited to a certain amount of information rather than information overload

“…There were a number of inconsistencies with your

performance?...”VS

“…If there was one thing you could change about your interaction,

what would it be?...”

8. Be verified by the recipient

Encourages & checks for insight“…You were terrific…”

VS“…How did you feel that situation

went?...”

9. Pay attention to the consequences of feedback

• Recognise the learners readiness to receive feedback

• Allow for response & interactionBe aware of verbal & non-verbal responses

to feedback

• Don’t correct a learner in front of a patient

• Don’t just focus on the negative• Choose appropriate language

10. Be honest, meaningful & objective

Provide relevant & meaningful feedback

Don’t say that was OK’ when it was notBUT

Don’t be brutal

Questions to ask yourself prior to giving feedback:

• What should be the frequency & timing of the feedback

• Is the learner a beginner in this task?

• What is the context of the learning situation?

Pendleton method of feedback

• Ask learner how they felt

• Ask learner what went well & why

• Teacher says what went well & why

• Ask learner what could be done better & how– Educator may add

• Summarise strengths & up to 3 things to concentrate on– May be done by student for verification

Follow up strategies • Not enough to just give feedback

• Need to work with learner on strategies to achieve goals/make improvements

• Learner and supervisor have roles in this

Unacceptable behaviour1. Check learner is ok before you begin

2. Use a wake-up warning phrase

3. Say, very simply what is not right

4. Provide an example as appropriate

5. Relax the tone to allow for a positive response

6. Respond to offer positively

7. Do not be drawn into discussion on justification

8. Most of us take criticism better if it is not personal

Supervisor Feedback

• Getting feedback as you as supervisor also important– “How can I better support you to

learn?”

• Develops respect• Enhance learning experience• Shared understandings

Feedback Activity

Your opportunity to give feedback…

Assessment• Formative phase

– Ongoing/occurs throughout– Informs progress– help learner improve

• Summative phase– Specific time– Judgement of performance + usually documentation

Appraisal tools

• Usually provided by educational institution

• Determination of competence

• Rating/grade

• Enables constructive criticisms

• Guidance for further development

• Examples of practice

Guidance for providing constructive comments

• General comments in relation to student performance should be supported with examples

“(student) consistently checks institution policies & procedures prior to performing procedures”

What questions do you have?

References

Bondy, K.M. (1983). Criterion – referenced definitions for rating scales in clinical evaluation. Journal of Nursing Education, (22), 376-381

Ende J.(1983). Feedback in clinical medical education. JAMA, (250),777-781

Gordon, J. (2003). One to one teaching and feedback: ABC of learning and teaching in medicine. British Medical Journal, 326(7388),543-545.

Pendleton, D., Schofield, T., Tate, P.& Havlock, P. (2004). The New Consultation, Oxford University.

Silverman, J., Draper, J., & Kurtz, S.M. (1996). The Calgary – Cambridge approach to communications skills teaching 1: Agenda led outcome based analysis of the consultation. Education in General Practice, (7), 288-299.

References

Stengelhofen, J. (1993). Feedback. In Teaching students in clinical settings, (pp. 153 – 179) London: Chapman and Hall.

Taras, M. (2006), Do unto others or not: equity in feedback for undergraduates, Assessment and Evaluation in Higher Education, (31)3, 365-377.

Van der Ridder et al. (2008)

University appraisal tools, Deakin University, Monash University.

Acknowledgement: Kiegaldie. D. (2008). Giving Effective Performance Feedback. Centre for Medical & Health Sciences Education. Monash University