Giving developmental feedback A generic skill Dr. Adrian Dunbar, Yorkshire Deanery

Feedback Some trainers treat their learners in a way that leads to improved performance Others undermine learners efforts and fail to develop their potential

Feedback Giving effective and constructive criticism is one of the most common concerns of educational supervisors Many consultants and GP trainers feel ill prepared in giving feedback on performance

Think about feedback you have received Positive? Negative? How did you feel? Why so? What effect did it have? What were the effective attributes?

Objectives Bringing out the best Motivating Raising self awareness Developing insight Enabling change Eliminating poor performance

Motivation Increases when success is expected Decreases when a goal is perceived as certain – or impossible Positive reinforcement increases the likelihood that a behaviour will be repeated

Unfortunately Often only the negative aspects are commented on And/or remembered Increasing anxiety about competence Leading to defensive cognitions and behaviour

Motivation occurs When people are clear about the task When they feel supported When effort is recognised When their contributions are valued When they feel free to express their views When they feel challenged to be more creative

Effective feedback is Descriptive – not judgemental Specific – not generalised About behaviour – which can be changed – not personality – which can t Sensitive to the needs of the recipient Selective and prioritised Timely – as close to the event as feasible

What are the attributes? Positive Mutual respect Genuineness Giving time Enthusiasm Unconditional positive regard Negative Humiliation Comment on personality No time for discussion Lack of interest Too late

Communications skills Active listening Open questions Facilitating reflection Enabling insight Challenge Summarising

NOT Judging Telling Providing solutions

Structure The trainee comments on strengths The trainer reinforces and adds The trainee comments on weaknesses The trainer reinforces and may add With evidence

An emotional bank balance Credits must be in place before withdrawals are made Credits must exceed withdrawals To avoid an emotional overdraft that is ultimately unsustainable The balance of support and challenge

Defensive reactions Recipient Blaming and scapegoating Denial Rationalisation Anger

Defensive reactions Giver Obligation Moral high ground Burying and fudging Minimising Colluding

Strategies Keep the focus positive Encourage ownership and responsibility Negotiate Time to reflect Explore and understand negative reactions

Feedback A life skill Tom your hair is so long – you look really scruffy - you can t see properly and you will get into trouble at school – I m only telling you for your own good. Its such a shame we can t see your handsome face – its your hair of course but don t you think it might impair your vision when driving – just a thought.