Giving Feedback: 3 Models for Giving Effective Feedback
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Not only is feedback essential for professional growth but it also provides direction and increases the confidence, motivation and self-esteem of the individual (Matua et al. 2014; Rose & Best 2005).
When delivered effectively, feedback can:
- Improve performance;
- Aid in learning;
- Help individuals understand their strengths and deficits;
- Allow learners to implement strategies to strengthen and improve their practice; and
- Ultimately improve patient care and outcomes.
Given the potential positives, it is important that giving feedback becomes a priority in our practices. Feedback in the healthcare setting, however, remains a challenge for many. We can all remember a time when we have given or received some poorly delivered feedback.
New graduates in particular not only need constructive feedback; they also need positive feedback to know when and what they are doing well. By understanding how well they are progressing, new staff can determine what new responsibilities they are ready to take on and what further learning should come next. Quality feedback helps the individual to realistically rate their clinical practice and help minimise any poor practices (Chang & Daly 2012; Matua et al. 2014).
However, giving feedback can be difficult.
You may be worried that the recipient will take your feedback the wrong way, or perhaps you feel you don’t have enough time to deliver feedback as constructively as you would like.
Additionally, when feedback is only given to focus on areas of improvement, without mention of areas where the learner is excelling, the learner can feel demotivated and devalued – especially in the case of a new graduate or staff member (Duffy 2013).
Healthcare workers need to take responsibility for their own behaviours and must be proactive in both seeking and offering feedback rather than feedback only being given in reaction to an adverse event or performance (Chang & Daly 2012).
The incidence of feedback can be encouraged by the recipient receiving it in a professional manner. This can then encourage and create a positive work environment where everyone gives and receives feedback openly.Giving Feedback
There are many sources of feedback in healthcare. For instance, a patient who had a smooth transition home can be interpreted as the result of good planning and providing sufficient patient information.
Colleagues can also be a source of feedback.
The use of several different sources of information will add credibility to feedback that is being given, whether it is positive or negative (Chang & Daly 2012; Rose & Best 2005).
New staff should also be encouraged to reflect on their practices and behaviours themselves, to determine their strengths and weaknesses. This will help identify areas in which they need continuing education and allow them to reach their full potential (Chang & Daly 2012).Feedback Models
There are many different feedback models available, and there is no ‘right way’ to give effective feedback. Which model you choose to utilise will depend on the feedback recipient and the situation.1. The Feedback Sandwich
This feedback tool consists of three components:
The feedback sandwich aims to minimise any detrimental effect the negative feedback may have on the individual and ensures that the learner is not discouraged (Matua et al 2014).2. Situation, Behaviour, Impact Feedback Tool
This tool allows the learner to reflect more on their actions whilst understanding precisely what you are commenting on and why, as well as what needs to change.
The situation, behaviour, impact tool offers the learner a chance to reflect on the situation from another perspective, and an opportunity to discuss with you strategies for improvement (Mind Tools 2017).3. Pendleton’s Model of Feedback
Pendleton’s model of feedback helps make the learning experience constructive by:
Areas of improvement are first identified by the learner and then followed up with a discussion about strategies to improve their performance (Chowdhury & Kalu 2004).
When receiving negative feedback, there can be a tendency for some learners to become defensive.
Feedback can challenge the learner’s views about themselves: it can create a sense of discomfort, which can then cause them to become defensive, and not only challenge the feedback provided, but also the credibility of the individual providing the feedback.
In this situation, the relationship between the two individuals is pivotal in ensuring the feedback is understood and the emotional state of the learner is protected (Delany & Malloy 2018).
It should be noted that negative feedback can also be perceived as criticism, even though the feedback may have been given with the intention of assisting the learner to improve. This can trigger feelings of shame and guilt.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 depending on the circumstances, 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 (Delany & Malloy 2018).The Feedback Environment
As an educator, it is important to build a safe feedback environment within which learners feel comfortable and supported. It needs to be an environment where feelings can be discussed, especially when mistakes are made and there are feelings of shame or guilt (Cox 2016; Van Der Leeuw 2014).
- Chang, E & Daly, J 2012, Transitions in Nursing: Preparing for Professional Practice, 3rd edn, Elsevier, Sydney.
- Chowdhury, RR & Kalu, G 2004, ‘Learning to give feedback in medical education’, The Obstetrician and Gynecologist, vol. 6, pp. 243-7.
- Duffy, K 2013, ‘Providing constructive feedback to students during mentoring’, Nursing Standard, vol. 27, no. 31, pp. 50-6.
- Matua, GE, Seshan, V, Akintola, AA & Thanka AN 2014, ‘Strategies for providing effective feedback during preceptorship: Perspectives from an Omani hospital’, Journal of Nursing Education and Practice, vol. 4, no. 10, pp. 24-31.
- Mind Tools 2017, The situation – behavior – impact feedback tool: Providing clear, specific feedback. Available from: https://www.mindtools.com/pages/article/situation-behavior-impact-feedback.htm
- Rose, M & Best, D (eds) 2005, Transforming Practice Through Clinical Education, Professional Supervision and Mentoring, Elsevier, Sydney.
- Sodeify, R, Vanaki, Z & Mohammadi, E 2013, ‘Nurses’ Experiences of Perceived Support and their Contributing Factors: A Qualitative Content Analysis’, Iranian Journal of Nursing and Midwifery Research, vol. 18, no. 3, pp. 191-7, viewed 16 February 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748536/
- Cox, S. (2016). Give the gift of feedback. Nursing Management, 47(5), online. Available: https://journals.lww.com/nursingmanagement/Fulltext/2016/05000/Give_the_gift_of_feedb ack.11.aspx
- C. & Molloy, E. (2018). Learning and Teaching in Clinical Contexts. Elsevier. Chatswood
- Hardavella, G., Aamli-Gaagnat, A., Saad, N., Rousalova, I. & Sreter, K.B. (2017). How to give and receive feedback effectively. Breathe, 13(4), 327-333. Online. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709796/
- Van Der Leeuw, R.M. (2014). Sharing is caring: Dealing with feedback and difficult feelings. Medical Education, 48 (11). Online. Available: https://onlinelibrary-wiley-com.epworth.idm.oclc.org/doi/full/10.1111/medu.12545
Sally Moyle is a rehabilitation nurse educator who has completed her masters of nursing (clinical nursing and teaching). She is passionate about education in nursing so that we can become the best nurses possible. Sally has experience in many nursing sectors including rehabilitation, medical, orthopaedic, neurosurgical, day surgery, emergency, aged care, and general surgery. See Educator Profile
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