1. Giving and Receiving Constructive Feedback
Gerry Altmiller, EdD, APRN, ACNS-BC

2. Look at Self First Monitor your own behavior It’s difficult
Become a vigilant self monitor

3. The Challenge
When confronted, embarrassed, challenged, rather than act emotionally ask yourself:
What do I really want for myself?
What do I really want for others?
How would I behave if I really wanted these results?

4. Focus for Dialogue Mutual purpose Mutual respect
Recognize what both parties want, ie: learn the topic; pass the course; graduate nursing school; reach a solution to problem
Mutual respect
Choosing words with caring
Maintaining the dignity of the other

5. What is Constructive Feedback?
Based on observations
Interactive process of critique to provide insight to correct errors and enhance learning
Unbiased, analytical reflection of what occurred
Should offer logical connections in order to influence successful learning

6. Purpose of Constructive Feedback
Influence future actions
Narrows gap between current performance and desired performance
Fundamental to learning

7. Categories of Feedback
Constructive or Corrective
Considered negative
Should be followed with advice for improvement
Reinforcing
Considered positive

8. Role of Constructive Feedback in Quality and Safety
Essential for continuous quality improvement
Identifies areas where improvement is possible
Negative consequences if avoided
Recognize value for patient safety
Helps one develop error detection skills

9. Role of Constructive Feedback in Teamwork and Collaboration
Evaluation is part of team process
Debriefing
Evaluate effectiveness of team
Identify areas where improvement is possible
TeamSTEPPS Training Video: Labor and Delivery Debrief
Click link above, then Click on arrow to view video

10. Role of Feedback in Delegation Process
Four steps to Delegation
Assess and plan
Communicate
Provide Surveillance and supervision
Evaluation
Nurse determines if delegation outcome was successful
Nurse needs to lead discussion when expectations are not met

11. Feedback and Professional Development
Essential for professional Growth
Learned Skill
View as opportunity

12. Focus of Constructive Feedback
Address faulty interpretations
Provide options for improvement
Most effective when focused on
Task
Process
Self-regulation; error detection skills
Least effective when focused on
Person him/herself
Feedback whether positive or negative should always be an unbiased reflection of events

13. Delivery is Critical Perception is everything Should be
Timely
Focused on learning
Presented with optimistic view
Providing Constructive Feedback indicates commitments to another’s learning and reinforces importance of what they do
Receivers should view as opportunity for improvement rather than review of deficiencies

14. Challenges Should not “put down” another
May be ignored if couched in subtle language
Concern over creating conflicts
Can be used to “shame” another
Correcting individuals in front of pts or peers
Ignoring individual
Displaying contempt for lack of knowledge
Taking over for another implying incapable
Causes disconnection from team

15. Receiving Constructive Feedback
Consider if this is repeating from several sources
If perceived as inaccurate, ask for examples and focus on learning
Understand that constructive criticism initiates self examination; reflection; growth as professional nurse

16. Why should students learn this skill?
Part of professional practice
Increases knowledge
Helps us develop expertise
Allows us to improve practice

17. How will Students Use this skill as a Nurse?
To support a culture of Safety
Can ask questions without fear of criticism
Maintain high quality care; CQI
As part of delegation process
During peer Review Process
For transition to practice
To increase professional growth & development

18. Technique Clear communication Concise, precise; no ambiguities
sender; receiver; acknowledgement
Concise, precise; no ambiguities
Use proper terminology
Allow opportunity for clarifications if need
Confirm any non-verbal cues (facial expression, eye contact, etc) to ensure patient safety

19. Strategies Model appropriate techniques for others
Focus on quality and safety aspects
Connect it to patient outcomes
Emphasize as opportunity for learning
Feedback with strategies for improvement
Debriefings after stressful patient situations
Be direct with colleagues about unacceptable behaviors
Identify individuals that will answer questions
Role playing until you feel comfortable
Use Reflection

20. Reflection Challenge yourself to speak with care
Continue to speak calmly even if interaction is escalating
Appraise interaction afterward
What went well?
What went poorly?
What could I have done Differently?

21. Key Points Learned skill Maintain dignity of other View as Opportunity
Recognize it’s value in maintaining patient safety

22. Thank you for listening.
Reference: Altmiller G. (September, 2012). The role of constructive feedback in patient safety and continuous quality improvement. Nursing Clinics of North America, 47(3) Contact: