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At the completion of this module you will:

  • Develop an understanding of why providing feedback is important
  • Know what makes successful feedback
  • Understand the challenges associated with giving feedback
  • Learn about some different practical models to assist in providing feedback
  • Explore different responses to Feedback
  • Have the opportunity to self assess your feedback style

 

What is the definition of feedback?

There is no definition that is universally accepted.

A large scale, mixed methods study was performed to identify what makes effective feedback.

Monash, Deakin and Melbourne Universities all participated in the project.

(Support for the project was provided by the Australian Government Department of Education and Training.)

The definition that was decided upon as a result of the study.

“Feedback is a process in which learners make sense of information about their performance and use it to enhance the quality of their work or learning strategies”

Process

The process of giving feedback is something that happens over time. It is not a once-off single act of “reception of information”.

A challenge in feedback design is that the process is an abstract concept – i.e. the feedback process (sequence, source, frequency, modality, detail, etc.) can look quite different – there is no universal design for that process. In addition, the process may, ideally, be different for each individual.

Learners

This definition is learner-centred – not defined based on what teachers do for them.

It represents a shift from a dominant understanding of feedback (comments provided by educators to learners). In this definition, information about performance could come from educators, but it could also be generated by the learner, her/his peers, others, or even automated systems. A challenge in feedback design is to not only to facilitate the generation of performance information through these diverse sources, but also to enable learners to make sense of information AND to demonstrate improvement.

Sense Making

A challenge in feedback design is the conceptualisation of the sense-making process. How do we make sense of something? What skills do learners need? What features of the feedback process facilitate effective sense-making?

Information

A challenge in feedback design is the need to consider what nature of information is most useful for learners (e.g. multiple sources, modalities, detailed, personalised, individualised, task oriented, metacognitive/thinking orientated etc.).

Performance

Because feedback uses performance information to enhance future work and learning strategies, it is logical that there should be many feedback opportunities.

Effect/Impact

 

How do educators or students know if feedback has an effect?

A challenge in feedback design is to set the conditions in which learners have opportunities to demonstrate improvement which is more than simply asking them to do a further task. 

It necessarily needs to also offer a chance for learners to judge their performance and evaluate it in relation to their changed work/learning strategies.

Watch this video below to learn about a teacher’s perspective of giving feedback in a primary school setting. (Scotland)

Think about what could happen if feedback is  given inappropriately??

  • Clinical care could be affected
  • Integrity of the profession may be compromised
  • Anxieties/inadequacies will not be addressed which could have an impact on the student’s performance and professionalism
  • Student may think their behaviour is appropriate
  • The student may have difficulties in accepting feedback in the future
  •  Learning may be inhibited & career progression delayed
  • The student may not been given the opportunity to manage issues and develop to their full potential

Reflection Activity

This activity encourages you to reflect on a challenging conversation that you have been involved in and explore some of the feelings that you experienced.

 

Recall your experiences of receiving feedback.

Think of an emotional feedback and what made it emotional or challenging.

What went well?

What did not go so well and why?

What makes a conversation challenging?

A challenging conversation is defined as an interaction between two or more parties characterised by:

  • Intense emotions
  • Different views or conflict about the topic
  • When it starts to impact on someone’s self-esteem or it becomes personal (or is perceived to be personal)
  • Uncertainty about how the conversation will finish
  • Caring about the person involved and potentially damaging the relationship
  • Anticipating that the conversation will not go well
  • Lack of support and not knowing what the next step is to address the concerns
  • A power imbalance ie. supervisor and supervisee (student)

(Patterson et al., 2002).

Feedback conversations with students are  challenging when addressing the following:

  • the student at risk of failing
  • unprofessional behaviour
  • poor communication skills with clients and co-workers
  • sensitive issues such as poor hygiene 
  • the disengaged/unmotivated student
  • the clinically unsafe student
  • illness – physical or mental health
  • the over confident student

What does the research say about providing feedback?

 

  • Learners complain that they do not get enough feedback or it is vague

 

  • Both parties may describe it as confronting and the educator may be afraid of undermining the learner’s self esteem – hard to give and take

 

  • Educators can get frustrated when they put considerable time into generating feedback and learners take little notice of it

 

  • Educators may think that their feedback is more useful than their learners think

 

  • Feedback is typically ‘telling’ and diagnostic in flavour, often lacking strategies for improvement, and often lacking opportunities for further task attempts

Ende 1995; Hattie 2009; Boud & Molloy 2013; Johnson & Molloy 2017

As shown in this image, it can cause discomfort for both the sender (typically the educator) and the recipient.

 

Is the sender’s job over once they have sent the information???

What enables effective feedback in an organisation?

1. Capacity for feedback
  • Learners and educators must understand and value feedback
  • Learners must be active in the process-must be able to evaluate their own performance (self-assessment rubric/reflective writing tasks), may need to seek out feedback
  • Educators need to seek and use evidence to plan and judge effectiveness
2. Designs for feedback
  • Information provided is usable and learners know how to use it
  • Tailored to meet different needs of the learners
  • Variety of sources and modes of delivery
3. Culture for feedback
  • It is valued and visible at all levels-opportunities for students to voice their concerns
  • Leaders and educators ensure continuity of vision and commitment
  • There is trust, inclusion, support, collaboration and a focus on wellbeing

Tips for giving effective feedback

  • Check that the person is ok before you start
  • Be open, accepting and genuine
  • Ask yourself what you would like to achieve from the conversation – plan what you want to talk about and what you will say-establish facts before the conversation
  • If need seek support from colleagues 
  • Make sure you are familiar with policies and procedures of the organisation and the university
  • Be timely and regular – give feedback as soon as practical and the more regular the more “normal” it becomes
  • Identify up to 3 key messages at one time
  • Be specific-give examples
Examples

General Feedback “You didn’t seem very empathetic.”

Specific Feedback “I couldn’t tell what you felt when she told you that she was upset- your facial expression didn’t change when you were listening-I felt she might have thought that you didn’t care”

General Feedback “Great job, well done”

Specific Feedback “You waited for the patient to explain what she was afraid of before reassuring her-Well done””

  • Ideally give feedback face to face
  • Appropriate setting/non-threatening
  • Focus on observed behaviour-not their characteristics
Examples

Evaluation/Judgmental Feedback “That was awful, I think you really shocked the patient when you didn’t explain that you were taking the cannula out.”

Descriptive Feedback “I noticed that you didn’t explain to the patient that you were taking the cannula out. This may have upset the patient”

  • Compare with target-reaching goals and expectations
  • Be aware of signs of feedback being rejected
  • Use positive body language and active listening skills
  • Conclude with an action plan
  • Welcome feedback from the student
  • Set clear expectations of performance
  • DON’T FORGET TO GIVE THE POSITIVE FEEDBACK

 

Reflection Activity

Remember the last time you gave feedback to a student.

Comment on all of the following aspects:

  • Was it timely?
  • Was it specific?
  • Was it constructive?
  • Was it given in an appropriate setting?
  • Did you use attentive listening?
  • Was it a two way dialogue?
  • Was there an action plan?
  • If you were in the same situation again, would you do anything different?

NEW ROLE, NEW CONVERSATION. A FRAMEWORK FOR MANAGING DIFFICULT CONVERSATIONS

One framework for managing challenging conversations is the ‘New role, new conversations’ framework developed by the Australian Institute for Teaching and School Leadership (AITSL)  (as seen in the figure below). The framework was developed to be used by school leaders in a school context, however can be applied to conducting challenging conversations in a clinical setting too.

For more information

A Framework for managing difficult conversations. Source: AITSL (2016, p. 3). Retrieved from: https://www.aitsl.edu.au/docs/default-source/lead-develop/scenarios/new-role-new-conversations.pdf?sfvrsn=dae0ed3c_2

feedback models

This feedback sandwich model

 

 

The Feedback Sandwich Model

       Challenges with this model

  • It is predictable and learners will see through it

 

  • It lacks authenticity-tokenistic

 

  • People will filter out the positive and focus on the negative

 

  • Preconstructed rather than constructed together

The Pendleton Model 

Pendleton, D. (1984)

  • Student states what was good about performance-connection with the student-also elicits insight and critical reflection
  • Teacher states area of agreement and elaborates-introduces/reinforces good practice
  • Student states what could have been improved-develops reflection skills
  • Teacher states what could be improved
  • Discuss how improvements could be made

The Set-Go Model

Silverman et al (1997)

  • What I Saw- Trainer describes what he saw
  • What Else did you see?- Trainer describes what he saw
  • What do I Think?- Trainer reflects back to the trainee what he thought
  • What Goals are we trying to achieve?- Trainer and trainee revisit what the desired outcome is.
  • Any Offers on how to achieve the goals?-Trainer and trainee discuss skills and solutions to achieve goals.

This ALOBA model

 

  • Start with learners agenda- get learner to ask supervisor what they want them to observe
  • What problems did you experience-help them to identify-why did it happen
  • Acknowledge and validate concerns
  • What would you do differently-suggestions
  • Summarise and clarify with student with what they would do next time
  • Provide another opportunity
Please see link below to watch video examples of the ALOBA model, the PENDLETON model and the SANDWICH model of giving feedback.

VIDEO EXAMPLES OF FEEDBACK MODELS

Watch this video which was developed by Griffith University (2013) and demonstrates a supervisors approach to having a challenging conversation with a student about performance.

Finishing a feedback conversation

Once finished you should reach a point where the learner has a greater understanding of their performance and  their future.

Never leave an evaluation discussion without covering:

  • Impact – what does this new understanding mean?
  • Consequences – how does this new understanding change things for them?
  • Future plans – what are they going to stop doing, start doing or keep doing?
  • Opportunity to reassess
  • Reflecting on how you felt the feedback went

common mistakes in giving feedback

Sugar coating negative feedback

When you’re afraid of hurting the other person’s feelings or triggering a negative response. BUT they cannot decipher what you’re trying to say or the seriousness of the matter

Caving in or backing down because the student is becoming upset

While taking a time-out may be the best response deciding that it is not worth it is never the appropriate response

Avoiding the conversation

This could lead to 

  • Decreased Morale
  • Relationship breakdown
  • Compromised Patient Care
  • Increased absenteeism
  • Learning experience compromised
  • Problem could be prolonged or exacerbated
Putting forward an action plan with first discussing the problem

Unless the student understands what the issue is and why it is important they are not going to agree with the action plan

Delivering a long warm up preamble before giving the constructive criticism

This just builds suspense for what they know is coming-

Using vague judgements without specific examples

Without concrete language, concepts like “more of a team player”, “more helpful”,  “more professionalism” and “show more initiative” are all meaningless-examples are needed

Not managing your own emotions

Hints to help manage your own emotions

  • Approach the situation rationally and objectively
  • Ensure body language is approachable and non-threatening
  • Use a low and calm tone of voice
  • Be empathetic
  • Speak slowly
  • Be clear and direct with your communication
Not using active listening skills

ACTIVE LISTENING SKILLS INVOLVES 

• being non-judgemental
• using open body language-arms uncrossed, eye contact maintained
• asking questions to facilitate learning
• seeking clarification to enhance understanding
•being genuinely interested
• summarising frequently to ensure understanding
• being aware of tone and paying attention to nonverbal  forms of communication in self and learner
• remaining calm, in control and relaxed
• allowing time to articulate thoughts
• paraphrasing before disagreeing to demonstrate active listening and understanding
• avoiding making vague, unclear or ambiguous comments

Source: https://www.heti.nsw.gov.au/__data/assets/pdf_file/0008/424862/allied-health-learning-guide.pdf

responses to feedback

Past Feedback

It is important to remember that learners also bring their prior experiences with feedback situations to their current feedback conversation. This can impact on how they respond to the feedback depending on the circumstance, their knowledge levels and their prior experience. For example, if the learner has had an experience receiving feedback that left them feeling demoralised, then this can have an effect on their emotional state when receiving feedback in the future. Therefore, it is important to establish any previous negative experiences with receiving feedback as well as how the learner prefers to receive feedback (Delany & Malloy 2018).

 

Mindset  Different learners will interpret the feedback in different ways.

Fixed vs growth personality traits – Fixed believe in natural talent eg intelligence, and that other qualities/traits cannot be taught. Growth believe that they can achieve anything if they work had enough at it through training, education and practice. A growth mindset individual attributes success to learning therefore are highly motivated learners and eager recipients of feedback, especially coaching. Based on the research of Carol Dweck, a psychologist at Stanford university.

What can you do with a student who shows characteristics of a fixed mindset?

  • Use language that focuses on performance for eg. instead of saying “you weren’t able to get the child to listen to you” you could say “it might be easier to get a child’s attention if you kneel down”
  • Establish a learner centred learning culture-normalise feedback
  • Encourage ongoing feedback seeking
  • Emphasise that professionals at all levels are expected to have strengths as well as areas for improvements

In this popular TED Talk below, Carol Dweck gives a powerful introduction to growth mindset and the power of believing that you can improve.

When the student disagrees

  • Is the student clear on the expectations
  • Try and understand intentions of the student (not just behaviour)-explore and be curious
  • Get the learner to self- reflect
  • Use specific objective examples
  • Use recording (video/audio)
  • Get someone else to observe the learner (peer or other staff member)
  • Get client to give feedback to student

Please see below a link to a self-reflection tool on how you provide feedback:

Providing Feedback Quiz

Evaluation

Evaluation is important to Going Rural Health. Please spare a moment to tell us what you think.

This link will take you to our evaluation page:

Evaluation