1. THE DOS AND DONTS OF GIVING EFFECTIVE FEEDBACK TO COLLEAGUES January 24, 2012 Department of Medicine

5. OBJECTIVES To identify both the opportunities and challenges in giving effective feedback to colleagues To identify both the opportunities and challenges in giving effective feedback to colleagues To describe key elements of constructive feedback To describe key elements of constructive feedback To consider the consequences of poor quality or absent feedback To consider the consequences of poor quality or absent feedback

6. CASE VIGNETTE #1 You will be meeting Dr. Enthused, a junior faculty member. He is somewhat apprehensive about this meeting as it will be the first time he is meeting with you to review his performance since he was recruited four years ago. Dr. Enthused spends most of his time doing clinical work and clinical teaching at the hospital. He is not particularly interested in research or other scholarly endeavors. His teaching evaluations are excellent. Dr. Enthused has not volunteered for any committees because he is so busy with his clinical and teaching load. HOW WOULD YOU APPROACH GIVING FEEDBACK TO DR. ENTHUSED?

7. CASE VIGNETTE #2 You will be meeting with Dr. Longtime for her annual performance review. She is a successful clinician-scientist and is responsible for a busy lab. She has won several national research awards. She does some teaching in the Basis of Medicine component of the curriculum, some clinical teaching on the ward (with residents) as well as supervision of graduate students in her research lab. Medical students and residents evaluate her teaching as below average saying that she appears unprepared for her lectures and does little bedside teaching on the ward. HOW WOULD YOU APPROACH GIVING FEEDBACK TO DR. LONGTIME?

9. QUESTIONS What is the role of feedback in the annual performance review? What is the role of feedback in the annual performance review? What characterizes effective feedback in this context? What characterizes effective feedback in this context? How can we improve the giving of feedback to our colleagues? How can we improve the giving of feedback to our colleagues?

10. Feedback: Return of a signal through an electronic circuit causing a high-pitched screeching noise

11. FEEDBACK Communication to another person which gives information about how he/she affects and is perceived by others. A way of helping another person consider changing his/her behavior.

12. Feedback should be given in a way that the receiver can hear it, that the receiver can hear it, understand it, and choose to use or not use it.

13. ARE WE DIFFERENT FROM OUR STUDENTS? Feedback is... Part of the learning process Part of the learning process Based on learning objectives Based on learning objectives Appropriate learning environment & opportunities Appropriate learning environment & opportunities Objective Objective Timely Timely Part of the academic and career developmental process Based on clear expectations Appropriate academic environment and opportunities Objective Timely

14. ARE WE DIFFERENT FROM OUR STUDENTS? Feedback is... Valued by the learner Valued by the learner Positive & reinforcing feedback is easy to give (and receive) Positive & reinforcing feedback is easy to give (and receive) Corrective and constructive feedback is harder to give (and receive) Corrective and constructive feedback is harder to give (and receive) Continuum between formative and summative Continuum between formative and summative Due process is important Due process is important Valued by faculty Positive & reinforcing feedback is easy to give (and receive) Corrective and constructive feedback is harder to give (and receive) Continuum between formative and summative Due process is important

15. OPPORTUNITIES To express appreciation To express appreciation To encourage dialogue To encourage dialogue To share information To share information To guide reflection To guide reflection To clarify expectations To clarify expectations

16. OPPORTUNITIES To advise To advise To explore new directions To explore new directions To mentor To mentor To identify emerging leaders To identify emerging leaders To promote excellence To promote excellence To jointly plan for the upcoming year To jointly plan for the upcoming year

17. CHALLENGES Fear of damaging the relationship Awkward to communicate Confrontational Nothing will change Assumption that faculty members instinctively know their strengths and weaknesses Past difficult experiences

18. THE COST OF AVOIDANCE Failure to reinforce desired performance Failure to reinforce desired performance Suboptimal performance unchanged Suboptimal performance unchanged Confirms faculty assumptions that all is fine Confirms faculty assumptions that all is fine Failure to meet faculty members needs Failure to meet faculty members needs Impact on role modeling and departmental culture Impact on role modeling and departmental culture Consequences on accreditation Consequences on accreditation Longterm effect on departmental success Longterm effect on departmental success

19. Failure to fulfill our role as LEADER

20. EFFECTIVE FEEDBACK: GENERAL GUIDELINES Should be viewed as a normal component of faculty life: expected and routine Performance criteria should be clear Specific behaviors and aspects of performance Non judgmental language (Use I statements) Limited in quantity Bi-directional dialogue rather than Chair/Chief-led transmission of information only Includes plans for future change

21. THE CAIRN MODEL OF CONSTRUCTIVE FEEDBACK Context (Individualized) Context (Individualized) Action (Performance) Action (Performance) Impact (Positive or negative) Impact (Positive or negative) Review (Common understanding) Review (Common understanding) Next steps (Action Plan) Next steps (Action Plan) T. De la Rosa

22. THE PENDLETON MODEL: REFLECTIVE FEEDBACK CONVERSATION 1. 1. The faculty states what is good about his or her performance 2. 2. The chair/chief states areas of agreement and elaborates on good performance 3. 3. The faculty states what area of performance could be improved 4. 4. The chair/chief states what he/she thinks could be improved

23. EFFECTIVE FEEDBACK: SPECIFIC GUIDELINES Related to goals defined in earlier meetings Related to goals defined in earlier meetings Clear and explicit expectations Clear and explicit expectations Based on objective data Based on objective data Aligned with departmental vision Aligned with departmental vision Positive feedback included Positive feedback included Expectations defined together for the upcoming year Expectations defined together for the upcoming year Dont make it personal! Dont make it personal!

24. DONTS Dont impose your views Dont impose your views Dont focus only on problems Dont focus only on problems Dont focus on personality issues Dont focus on personality issues Dont include sarcasm or anger Dont include sarcasm or anger Dont avoid the difficult situations Dont avoid the difficult situations Dont give mixed messages (but...) Dont give mixed messages (but...) Dont give a long rambling monlogue! Dont give a long rambling monlogue!

25. DOS Plan ahead Plan ahead Come prepared Come prepared Ensure your colleague comes prepared Ensure your colleague comes prepared Use objective information Use objective information Be specific Be specific Be timely and regular Be timely and regular Commit to regulated honesty Commit to regulated honesty Accept to receive feedback Accept to receive feedback

26. DOS Ensure privacy Ensure privacy Take the necessary time Take the necessary time Do a lot of listening (80-20) Do a lot of listening (80-20) Develop future goals and plans collaboratively Develop future goals and plans collaboratively Be concrete and specific Be concrete and specific Ensure expectations are clear and understood Ensure expectations are clear and understood Value and reinforce the relationship Value and reinforce the relationship Document the process Document the process

27. CONCLUSION The trouble with opportunity is that it always comes disguised as hard work Anonymous