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At the completion of this module you will:

  • Develop an understanding of why receiving feedback is important.
  • Understand the qualities of good feedback.
  • Learn about some different practical models and how you can prepare yourself to receive feedback.
  • Explore different responses to feedback and how to manage these responses.
  • Develop some strategies if you are not receiving appropriate feedback.
  • Have the opportunity to self assess how you receive feedback.

 

 

 

 

 

 

 

Even when Roger Federer was the no. 1 tennis player in the world he was still asking himself and others on how he could improve. 

Feedback is a crucial element of on-going development for all health clinicians regardless of where they are in their careers. We all must be open to receiving feedback and the organisation must value and support feedback at all levels.  

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 receiving feedback is something that happens over time. It is generally 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 the learner.

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.

The Reasons why it is important to engage with feedback

Think about what could happen if you do not receive or engage in the feedback process??

 

  • Clinical care could be affected.
  • As a student you may be unaware that you are at risk of failing.
  • Integrity of the profession may be compromised if you continue to make mistakes that you are unaware of.
  • Possible anxieties/inadequacies will not be addressed which could have an impact on your performance and professionalism.
  • You may think your behaviour is appropriate when it may not be.
  • You may have difficulties in accepting feedback throughout your career.
  • Learning may be inhibited & career progression delayed.
  • You may not been given the opportunity to manage issues and develop to your full potential.
  • Relationship building with your supervisor may not develop.
  • You won’t get the opportunity to practice communication/listening and self reflection skills.

expectations of students in the feedback process

You should understand and value feedback

There is no point engaging in a feedback conversation unless you understand the purpose and goal in receiving the feedback and the value it brings to you as a health professional

 

You should seek feedback and engage in the feedback conversation

It is beneficial for you to engage in the feedback process with multiple diverse sources, both before and after a task or performance of an activity. You may need to start this feedback process yourself, such as by seeking out comments from educators, peers, or clients.

This diagram depicts the possible multiple episodes of feedback that may occur to  enable you to make changes before further feedback discussion happens.

You should be able to self reflect

Evaluative judgement is an important part of learning, in which you develop self-regulation through the ability to make judgements about your own performance. You should be given the opportunity to appraise your own learning. This could be through a self-assessment rubric or by completing reflective writing tasks.

Be aware of your emotions

Feedback can be emotional for both parties.

Emotion influences many of our cognitive processes—including attention and memory —both of which are important at the time of the feedback process and afterwards as individuals reflect on their feedback encounters.

Developing our awareness of emotions strengthens our ability to respond intentionally (rather than habitually reacting) to situations in a helpful way.

For those who would to explore mindfulness further please see below links to courses taught by Associate Professor Craig Hassad and Dr Richard Chambers, who are experts in mindfulness and excellent teachers. These courses have been rated by class central as the leading online mindfulness courses in the world – and they are free!

 

Maintaining a Mindful Life

https://www.futurelearn.com/courses/mindfulness-life

 

Mindfulness for Wellbeing and Peak Performance

https://www.futurelearn.com/courses/mindfulness-wellbeing-performance

 

Be PREPARED for these questions!

  • How did you think you went?
  • Why did you make that decision?
  • Can you be more specific?
  • Are there any other options?
  • Would you do anything differently next time?

Reflection Activity

Think about a situation in the past where feedback caused an emotional response for you.

What made it emotional or challenging?

What went well in the conversation?

What did not go so well and why?

 

What makes a conversation emotional?

An emotional conversation is defined as an interaction between two or more parties characterised by:

  • 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).

Tips to manage your emotions

  • Develop an awareness of your emotions-get to know your trigger points.
  • Approach the situation rationally and objectively
  • Ensure body language is approachable and non-threatening.
  • Use a low and calm tone of voice.
  • Be clear and direct with your communication
  • Take a break if need be.
  • Are there external influences that may be causing an over-reaction? Are there stresses that the supervisor is unaware of? Having a conversation about this will help your emotions.

Positive and negative thinking and feedback- How can we change our brains for the better-by Rick Hanson

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???

some OF the feedback models educators may use-be prepared!

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)

  • You state what was good about your performance-this shows the supervisor insight and critical reflection
  • Teacher states area of agreement and elaborates-introduces/reinforces good practice
  • You state what could have been improved-this develops your reflection skills
  • Teacher states what could be improved
  • Discuss collaboratively on how improvements could be made

The ALOBA model-Agenda Led Outcome Based Analysis- this is a great model to use if you need more specific feedback on a task

 

  • Start with your agenda- tell the supervisor what you want them to observe.
  • What problems did you experience-try and identify why it happened.
  • What would you do differently-seek suggestions from the supervisor.
  • Summarise and clarify with the supervisor what you would do next time.
  • Ask for another opportunity to undertake the task.

Finishing a feedback conversation

Once finished you should reach a point where you have a greater understanding of your performance and your future.

Never leave an evaluation discussion without covering:

  • Impact – what does this new understanding mean?
  • Consequences – how does this new understanding change things for you?
  • Future plans – what are you going to stop doing, start doing or keep doing?

 

Reflecting on how you felt the feedback went:

  • Was it timely? Was it as close to the event as possible?
  • Was it specific? Were you told exactly what you could do to improve?
  • Was it constructive? Will it help to develop skills?
  • Was it given in an appropriate setting? If there was an incident was the discussion held privately? If it was positive was it done in front of the team or in front of a patient?
  • Did you understand the feedback? 
  • Did you use attentive listening?
  • Did you paraphrase to show your understanding?
  • Was it a two way dialogue? Who did most of the talking?
  • Was there an action plan?
  • Have you been a given another opportunity to practice or reassess?

responses to feedback

Past Feedback

It is important to remember that you potentially can bring your prior experiences with feedback situations to your current feedback conversation. Negative or demoralising feedback can affect your sense of who you are and this can impact on how you respond to the feedback in the future. It can help to be open about how you may feel about receiving negative feedback.

We are all wired differently on how sensitively we take feedback. 

Mindset-Different learners will interpret the feedback in different ways.

Fixed vs growth personality traits – People with fixed traits believe in natural talent eg intelligence, and that other qualities/traits cannot be taught. Those with Growth traits believe that they can achieve anything if they work hard 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.

This is based on the research of Carol Dweck, a psychologist at Stanford university.

 

If you fell you may have a “fixed” mindset  please watch the video below for some tips on how to develop a “growth” mindset

Tips on what to do when you disagree or unsure what to do with the feedback!

  • Have you had this feedback before? If so explore how you can change.
  • If need be, take time out to self reflect and think about the questions you could ask.
  • Are you clear on the expectations discussed with your supervisor? If not, clarify.
  • Ask for specific objective examples
  • Ask to be shown-what can they see that you can’t?
  • Get someone else to observe you (peer or another staff member)-there is nothing wrong in seeking a second opinion.
  • Get the client to give feedback to you
  • Make suggestions yourself of how you could improve- if unsure seek advice.
  • Work with your supervisor in developing mutual goals and ways to improve and use active listening skills.
  • Ask for the opportunity to share how you felt the feedback session went.

The supervisor is judging you on your behaviour and actions which may be different to your intentions.

Others are judging your performance based on your behaviours and their interpretation of your behaviours.

Then you need to work out why your thoughts, feelings and intentions did not translate through your behaviour as you intended.

 

 

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

Receiving feedback Quiz

want to learn more ?

Douglas Stone and Sheila Heen have spent the past fifteen years working with corporations, nonprofits, governments, and families to determine what helps us learn and what gets in our way. In Thanks for the Feedback, they explain why receiving feedback is so crucial yet so challenging, offering a simple framework and powerful tools to help us take on life’s blizzard of offhand comments, annual evaluations, and unsolicited input with curiosity and grace. They blend the latest insights from neuroscience and psychology with practical, hard-headed advice.