Feedback to Colleagues: Overcoming Barriers and Enhancing Impact A teaching hospital of Harvard Medical School Feedback to Colleagues: Overcoming Barriers and Enhancing Impact David H. Roberts, MD Associate Director, Carl J. Shapiro Institute for Education & Research Associate Director, The Academy at HMS Associate Professor of Medicine, HMS Education is at the heart of patient care.

Is the conversation different with a trainee versus a colleague? Unlike giving feedback to a trainee after a clinical observation which tends to be a one-sided conversation about what the trainee did well and what they could improve upon…the goal of a post-observation of teaching discussionis to forge a collaborative partnership in which both parties explore best teaching practices. 2

Unique aspects of giving feedback to colleagues

Mutually Beneficial Discussion Exchange of ideas Exploration of best teaching practices Discovering new perspectives on teaching 5

4 Key Elements Establish “learning” rather than “performance” perspective Agreed-upon ground rules Specificity and concrete examples Awareness of biases and observer’s perspective Cushing, Medical Teacher, 2011 6

Halo Effect Extension of a positive impression of a person to the judgment of his/her entire performance

Horn Effect Extension of a negative impression of a person to the judgment of his/her entire performance

The “Similar-to-Me” Effect Tendency to favor people who are professionally similar to oneself 9

Teaching Perspective Beliefs and experiences that underly one’s teaching style Exposing observers to their own perspectives and discussing other equally effective perspectives reduces the similar-to-me bias. Courneya, Teaching and Teacher Education, 2008 10

Teaching Perspectives Inventory www.teachingperspectives.com

Rewind the Experience Reflect on what you witnessed about learner engagement, group dynamics, and teaching strategies from your viewpoint “Mirror” back concrete examples and quotes Ray Vella 12

Ask-Tell-Ask Model Did you notice that the medical student spent most of the time looking at his iPhone? He looked disengaged to me. What are some ways to include the student in the discussion next time? Black, CA Cancer J, 2005

Use of Personal Pronouns You - statements when praising behavior “You really know the medical students well!” I – statements when suggesting changes to behavior “At the start of a session, I find it helpful to have everyone state what they are interested in learning from the discussion. Vasquez, Linguistics and Education, 2004 Praise is more effective when it is personalized; Suggestions for behavior change are more effective when you use the first-person or third person pronoun 14

Use of Personal Pronouns Third-person – statements when suggesting a new approach “Priscilla uses this very interesting technique when she teaches the medical students…” I and we – statements when exploring a dilemma “I’m glad that student gave the wrong answer; it’s difficult to know what we’re supposed to do when that happens.” Lemov, Culture of Practice, 2012 Praise is more effective when it is personalized; Suggestions for behavior change are more effective when you use the first-person or third person pronoun 15

How Did I Do? Your colleague’s predominant expectation is to gain a verdict about his/her teaching competence. Hatzipanagos, Int J of Teach and Learn in Higher Ed, 2006.

Feedback is emotionally charged and may be perceived as a threat

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