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Giving constructive feedback

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The ability to give and receive constructive feedback is crucial to the success of any professional workplace relationship

It is a general assumption in society that nurses ‘do a great job’. But in the hectic schedule of daily work, constructive and specific feedback between nurses can be lacking.

Giving feedback is what we do when we offer our opinions or evaluations of someone else’s behaviour or performance.

It is an essential and effective tool in boosting much-needed morale, supporting career progression and encouraging good teamwork.

How often have you felt really good about yourself when someone praises work you have done?

Feedback can also be provided to staff above you. Many managers will want to receive feedback on how you feel things are going.

So what are the benefits of giving feedback? It should make people feel that their efforts and contributions are valued.

Positive feedback acts as reinforcement, strengthening the likelihood of the desired behaviour continuing. It can guide and suggest ways to improve performance and help to build relationships.

There are basically two types of feedback. Informal feedback might be a chance to tell someone that you have appreciated her or his particular efforts. This might be at the end of a difficult shift on the ward or a chance meeting in a corridor.

It has often been said that nurse managers do not do enough of this.

Formal feedback, as the name suggests, should be more planned and structured. Examples include appraisals, discussions following a particular piece of work, and feedback after an unsuccessful job interview.

Whitmore (2002) identifies five common levels of feedback. Examples are listed below from the least useful to the most useful:

‘You are useless’ - this is a personalised criticism that devastates self-esteem and confidence and will make future performance even worse;
‘This report is useless’ - while this judgemental comment is directed at the report and not the individual, it provides no information on how to improve the report;
‘The content of your report was clear and concise, but the layout and presentation was not very professional’ - this gives some positive feedback with some information to act on, but there is insufficient detail and it does not involve the individual;
‘How do you feel about this report?’ - the performer now has ownership, but is not encouraged to give much useful information.
A likely response is ‘OK’, ‘fine’ or to make some other value judgement such as ‘lousy’ or ‘great’, rather than a more useful description;

‘To what extent do you think the report achieves its purpose? What other points do you think need emphasising?’ - in response to a series of questions such as these, the performer/learner gives a detailed, non-judgemental description of the report and the thinking behind it, and provides opportunities to improve it.
It is important to distinguish between constructive feedback, praise and criticism. Praise might be something like, ‘You did a great job on that project - well done’, while criticism could be, ‘You were not much help on that project’.

Both of these are personal judgements and information given is vague and focuses on the individual not the task, and is merely based on feelings and opinions.

Constructive feedback is objective, non-judgemental, based on specific observations, encourages discussion and allows a positive course to be set for the future.

There are four aspects to giving constructive feedback. First is the content. It is important to identify specifically the issue of performance involved. Statements such as, ‘That was a job well done’ do not go far enough. What specific aspect of the performance did you like and why?

Second is the manner of the feedback. You should be sure that the person knows what was required. Focus on the problem, not the person. You should be direct when delivering feedback and avoid giving mixed messages. Don’t ‘beat about the bush’.

Feedback should be given in person and in private. Allowing other people to see and hear the discussion will embarrass all concerned. Tell the staff member exactly what you have observed without diluting your thoughts into generalisations. If possible, give dates and places.

You may have made a written record of the observations over a period of time. If there is a long-standing issue then making notes is important. Make use of these notes. This will confirm that you have done your homework and are well prepared. You should always state specific observations, not just your interpretations.

Most of all involve the person in the discussion. Although you should be armed with some solutions, the person concerned should be encouraged to participate in the problem-solving. Asking them how they think their performance is going is often a good starting point.

You should aim to focus on solutions. Remember, you are giving feedback to correct a problem, not to ‘browbeat’ the person concerned. Summarise the discussion at the end so that you both clearly understand what has been said and what has been agreed upon.

If necessary, arrange a follow-up meeting at which time you can both review progress.

The third point is timing. Positive feedback should be given as quickly as possible for it to have the desired effect. Feedback that is more formal and possibly more complex needs a little more consideration.

It is important to take some time to plan your feedback session so that it can be constructive and you can both learn from it. But never leave it too long or it will lose its impact.

Lastly there is the issue of frequency. How often should feedback be given? Constructive feedback may need to be given more often for newer staff who need to know how they are fitting into the team. A general principle is that you should ensure that positive feedback outweighs negative feedback.

Nurses should observe these principles as far as possible when receiving feedback from their manager. Plan for any proposed formal feedback session, and be prepared to be involved in the process and offer opinions.

If you feel that the person giving the feedback is not offering to involve you, then suggest that you have further opinions.

Try to make sure that a summary of the discussion takes place and both parties agree on what is to happen next.

Feedback provides reassurance and support. It is vital that positive feedback is given on a regular basis as this helps to motivate people.

By actively participating in the feedback process, nurses can see how important aspects of their job and career are progressing.

The five principles of constructive feedback

Prepare carefully for any formal feedback session regardless of whether you are the recipient or the provider of the feedback.
Think about the content of the information you are going to provide during the feedback session. It should be specific and to the point.
The feedback should focus on the issue, not the person.
Consider the timing of your feedback session. Plan it so that you both have an opportunity to benefit from the experience.
In general terms, positive feedback should outweigh negative feedback.

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