COMMUNICATION SKILLS

Section 4: Giving Constructive Feedback

In this section we will cover some of the most difficult Students simply will not develop their full potential if
communication issues practice educators face; - providing practice educators fail to tell them where they need
constructive, effective and assertive feedback to others. improvement. Honest feedback allows the student to know
This may be for example, through informal or formal where they are and what steps they can take to improve
supervision, or through performance appraisal processes. themselves.
We will also highlight insights that we have gained in
previous sections to understand the rationale behind Feedback can also be reinforcing. If given properly,
feedback strategies. feedback is almost always appreciated and motivates
people to improve. Honest feedback can also strengthen
the credibility of the practice educator.
It is normally not difficult to give positive feedback to people
doing well or in general, to give information that people want However, it is also important that feedback is given in a
to hear. Most of us can do this fairly well. However, giving supportive and encouraging way, so that the student does
negative or critical feedback, or information that people do not feel constantly criticised, afraid and tense.
not want to hear, can be much more problematic.
Nevertheless, it is critical that feedback be honest. There are a number of guidelines toward giving feedback
effectively, i.e. so that it can be used constructively rather
Why are practice educators – and others, so reluctant to than incurring overly defensive reactions. The following
provide feedback? The reasons are many: points are recommended by Levinson (quoted in Goleman,
1996 p.153):

• Fear of the other person's reaction. People can

become defensive and emotional when confronted • Be : Feedback should highlight specific
with critical feedback, as their basic needs to feel events or examples rather than just general advice.
competent and accurate are threatened. Some It should also be specific about what the person
did. (Avoid generalisations i.e. words such as
practice educators are fearful of the reaction.
‘never’, ‘always’, ‘all’ etc).
• The practice educator may feel that they do not
have enough concrete, objective evidence to back • : Feedback should suggest ways of
up their feedback, should the student refuse to resolving any problems. There is little or no point in
accept it. offering negative feedback where there is no way
that a person can improve.
• Fear of causing tension in the work environment.
• .
• Many practice educators would prefer to take on
the role of a supportive coach rather than a judge. • : This is simply a reminder that
However, giving feedback often forces a change in feedback, even negative feedback, should be
this role. delivered in a positive way rather than simply
attacking the other person.

Further guidelines are given by Wertheim (2005)

It is important to note however that practice educators owe

• :
their students nothing less than clear, honest, concise
Feedback should focus on issues, not the person
feedback, so they know where they stand at all times.
since the individual usually has little control over

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COMMUNICATION SKILLS

Section 4: Giving Constructive Feedback

personality. It is important that we refer to what a • It involves the

person does rather than to what we think he is. rather than the amount we would like to
(Thus we might say that ‘the patient’s fears about give. To overload a person with feedback is to
the procedure were not listened to and addressed reduce the possibility that he may be able to use
by the student’ rather than calling the student what he receives effectively. When we give more
’insensitive’). than can be used, we are more often than not
satisfying some need of our own rather than helping
• : People more readily the other person.
receive information if the sender describes what
happened and communicates the personal effect it Still further characteristics of effective feedback beyond
had, as opposed to evaluating its goodness or those mentioned, are offered by McClure (2005, P.9):
badness, rightness or wrongness.
• Feedback should be regular.
• the feedback. Use "I have a
problem with your work", not "others have been • It should be reciprocal.
complaining".
• It should include recommendations for
• with the other, that they understand what improvement.

Communication Skills
has been said. Check whether they are willing and
• It should deal with decisions and action rather than
able to accept it. One way of checking
assumed intentions or interpretations.
understanding is to have the receiver try to rephrase
the feedback. No matter what the intent, feedback • It should be based on information which is objective
is often threatening and thus subject to by first hand observation.
considerable distortion or misinterpretation.

•
: Non-verbal behaviours such as tone of
voice, facial expression, posture and gestures, as
well as choice of words are crucial here.

• , not invalidating, and supportive. It is

important to acknowledge the other person's
uniqueness and importance.

• to the receiver and

directed toward
. A person gets frustrated when
reminded of some shortcoming over which he has
no control. Ideally feedback should be solicited, not
imposed.

• Feedback is useful when (soon after the

behaviour; depending, of course, on the person's
readiness to hear it, support available from others,
and so forth). Excellent feedback presented at an
inappropriate time may do more harm than good.
 COMMUNICATION SKILLS

Section 4: Giving Constructive Feedback

Giving feedback in a sensitive, problem-focussed way can significantly affect how it is heard and subsequently handled.

a. Consider the relative impact of each of the following pairs of statements.

b. Return to the guidelines for effective feedback above. For the second statement in each pair, note which guideline
it seems to relate to.

1. ‘You are always late. You never get here on time.’ Versus ‘I notice that this is the third morning this week that you
have arrived late for work.’

2. ‘You have created a problem here!’ Versus ‘How can we solve this problem?

3. ‘That was a terrible way to handle that situation’Versus ‘Here is what happened… My reaction is … The
outcome has been…’

4. ‘That’s not a bad idea, but I don’t think the rest of the team would go for it’ Versus ‘I can see your point, but I
don’t think it would work because…’

5. ‘You probably won’t have any ideas to contribute to the development meeting’Versus ‘You might have some ideas
or suggestions also’.

6. ‘You are just making too many careless mistakes. You’re not doing the job properly’Versus ‘We have discussed
what happened. What do you think are the obstacles standing in the way of improvement?’

7. ‘You really rushed that procedure to try and get away early’ Versus ‘When you went through points 1 to 3, you
didn’t pause to complete point 2 as we had discussed. This meant that …’

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 COMMUNICATION SKILLS

Section 4: Giving Constructive Feedback

As we saw in the guidelines to the above exercise This should involve open questions
(Appendix 1) feelings of defensiveness can occur whenever (e.g. How do you feel your placement is going? How do
a person feels threatened or punished. As Wertheim (2005) you see your performance?). The student can raise
notes, self-protection becomes very important when this potential problems themselves, and is involved
happens and energy is spent on constructing a defence collaboratively from the start.
rather than on listening. Aggression, anger, Some advocate the value of using a
competitiveness, and/or avoidance are common reactions.
‘feedback sandwich’ when giving negative or critical
feedback. This involves surrounding the critical with positive
We also saw that badly delivered feedback can result in feedback, so that the person hears the more positive
feeling that we are seen as insignificant in some way. When information at the beginning and end of the statement.
a person feels put down, ineffectual, or insignificant
because of the communication, Wertheim (2005) notes Wertheim (2005) advises that when preparing to give
that they tend to invest in attempts to re-establish selft critical feedback, initially state the constructive purpose of
worth. Energy is thus spent trying to portray selfw it (an example might be ‘I am concerned about some things
importance rather than on listening; and common reactions
you have said to patients, and it is important to me that we
may be showing off, self-centred behaviour, withdrawal,
talk about it’). He also suggests giving the other a chance
and or loss of motivation.

Communication Skills
to respond (e.g. what do you think?). Other techniques as
listed above (e.g. being specific, sensitive, probleml
It is therefore important to use techniques for effective feedback oriented, and checking understanding and degree of
and to think about how you might structure the process.
agreement) could also be useful here. Pay a lot of attention
to the consequences of the feedback, in both verbal but
also (perhaps more importantly) non-verbal reactions of the
As mentioned, situations where you may be giving feedback student. You should be acutely aware of the effects of your
to a student can range from informal to the more formal feedback on the student.
settings. The following structure gives steps that could be
applied to more formal settings (e.g., the appraisal interview) As practice educator, you should also be prepared to
however some aspects may also be applicable to less receive feedback yourself, as non-defensively as possible.
formal situations (adapted from Hargie et al, 2004, P.388). Model openness to both positive and critical feedback.
The information that you get may be very valuable. Ask for
Let the student know in advance of clarification, summarize, check for accuracy, listen
where and when the meeting will be held. Try and ensure carefully; mentally note questions; and paraphrase what
there will be no interruptions. you have heard (Wertheim, 2005).
Agree the nature of the meeting, i.e. that
aspects of performance will be discussed. This allows the Try and let the student
student to prepare also. take the lead. You could then offer suggestions to develop
or improve upon their ideas. Be more directive if the
This should include agreement on how
student shows an inability or reluctance to come up with
the meeting will proceed, (e.g. firstly discussing the last
any ideas. (E.g. ask ‘Is there any one behaviour you can
action points, what worked well and where you/the
department helped or hindered the work effort, new action change that would improve your performance?’).
points etc.).
Some sources advise that the person in Summarise what has been agreed,
authority’s office is likely to activate anxiety and advise and provide some sense of direction.
using a neutral space or the employee’s work venu