Giving Feedback
Optimising Feedback
Providing and receiving feedback is essential in the teaching and learning process. The provision of effective feedback can be one of the most important tools in facilitating student learning. As a workplace educator, you will be required to give feedback on a student’s performance while they are on placement at your workplace. It is likely that you will also receive feedback on your performance as a supervisor. Feedback can be given at any time and often occurs during informal or formal supervision and through the evaluation process. Giving feedback effectively is a skill, and like all skills, it takes practice to build confidence and competence. This module will explore the giving and receiving of effective feedback and the methods, timing and content of effective feedback. This module includes: • • • • • • • • • • • •
Introduction How feedback works: The Johari window model How is feedback different from evaluation? Strategies for effective feedback How do I provide feedback? When do I provide feedback? Structuring feedback Overcoming the challenges of giving feedback Feedback tips Managing the response to feedback Summary / Example References
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Introduction As discussed previously in the module, You as an Educator, providing feedback is an important role of the workplace educator. As an educator, your role in giving feedback is essential to allow the student to develop and gain the most from their placement. Giving feedback is the process we use to advise the student of our perceptions of their performance. Giving (and receiving) feedback is important for effective training and skill development. The feedback process tells students how others see them and helps them to identify strengths and areas for growth in professional competencies.
Observer
Feedback
Instructor Manager
Counsellor
Evaluator
Roles and Relationships of an Educator
(Adapted from Turney et al. (1982, cited in Best, 2005, p.48))
How feedback works: The Johari window model The Johari Window is a model developed by psychologists Joseph Luft and Harry Ingham to describe how humans interact, including the process of giving and receiving feedback (Luft, 1969). The model is used as a tool to foster self-awareness and understanding of group processes and interaction. The window is illustrated below and has four quadrants or panes. The Open pane is the part of ourselves that we see and others see. The Blind Spot is the aspect that others see but of which we are not aware. The Unknown is the unconscious or subconscious side of us, seen by neither ourselves nor others. The Hidden pane is our private space, which we know but keep from others.
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Known to others
Not known to others
Known to Self
Not known to self
OPEN
BLIND SPOT
HIDDEN
UNKNOWN
The Johari Window (Luft ,1969).
Receiving feedback enlarges the Open quadrant by reducing our ‘blind spot’. The receiver of the feedback learns things about themselves of which they were previously unaware. This applies to both the student and the educator. It is possible to increase the Open pane and reduce the Hidden pane through self disclosure. Sharing something of ourselves, previously unknown to the student, may assist in the development of trust. This is useful in developing a relationship with the student so they feel comfortable and safe and learning is enhanced. The module, Facilitating Student Learning, has more information about developing these aspects of the supervisory relationship.
Think about a time when you received feedback on your performance. • What was positive/ not positive about the situation? • What did you learn from the feedback about yourself?
How is feedback different from evaluation? Feedback and evaluation are crucial components of a student placement however it should be noted that they are different and serve different purposes. These are highlighted below. Feedback • • •
provides the student with objective information and insight about actual performance and how it relates to performance expectations, as well as the consequences of actions is formative and points the student in the direction of improving professional competency and moving toward goal achievement encourages reflective and self-evaluative practice
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Providing feedback serves a number of purposes. It can be either positive or constructive to: • • •
indicate the level of competence of the student; instruct to change/improve behaviour; and motivate a student’s desire to perform well.
Evaluation • •
is summative and presents an assessment about how well a student has performed and/or met a given goal or competency usually follows feedback and a period of effort at improving performance in identified skills or competencies, within a time-frame
(Ende, 1983; Branch & Paranjape, 2002)
Consider a situation where you will have to give feedback to a student & review the following questions: • What am I looking for? • How will the student demonstrate this? • How will I document observations for feedback e.g. a diary, notebook • How will I deliver the feedback? • How will I give ‘negative’ or constructive feedback? What if the student gets upset? • How will I deal with receiving feedback from the student? Document your answers to these questions and review them at the end of the module.
Strategies for Effective Feedback Price and O’Donovan (2006) suggest that effective feedback starts with a set of explicit criteria and standards that the student understands, and which form the basis for both feedback and evaluation. Students need to be encouraged to engage actively with these criteria and standards throughout their placement and with feedback provided by the workplace educator, other staff or other students. Students need to practice reflection to assist with their learning and development while on placement. Further information about reflective practice and activities to facilitate this can be found in the module, Facilitating Student Learning. Your goal as a workplace educator is to deliver feedback in a respectful and constructive manner, which will help the student learn and develop. For feedback to be helpful, it should be clear and specific and relate to the criteria and standards established at the commencement of the placement. When a negative comment or correction of a particular behaviour is necessary, clear justification for James Cook University Workplace Educator Program June 2011
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an alternative approach should be provided. The giver of the feedback should always check that the receiver has fully understood the points being made. An acronym to help remember how to give effective feedback is ‘CORBS’: Clear; Owned; Regular; Balanced; and Specific (Hawkins & Shohet, 1989). • •
•
•
•
Clear - try to be clear about what the feedback is that you want to give. Being vague and faltering will increase the anxiety in the receiver and may not be understood. Owned - The feedback you give is your own perception and not an ultimate truth. It therefore says as much about you as it does about the person who receives it. It helps the receiver if this is stated or implied in the feedback, e.g. “I found that …” rather than “It’s obvious that…” Regular - If the feedback is given regularly it is more likely to be useful. If this does not happen there is a danger that grievances are saved until they are delivered in one large package. Try to give the feedback as close to the event as possible and early enough for the person to do something about it, that is, do not wait until someone is leaving to tell them how they could have done the job better. Balanced - It is good to balance negative and positive feedback and if you find that the feedback you give to any individual is always either positive or negative, this probably means that your view is distorted in some way. This does not mean that each piece of critical feedback must always be accompanied by something positive but rather a balance should be created over time. Specific - Generalised feedback is hard to learn from. Phrases like, “You talk too much” can only lead to hurt and anger. “You talk too much to the client while you are administering an assessment” gives the receiver some information which he or she can choose to use or ignore. Physiotherapy provides Examples of Key Performance Indicators - a useful, comprehensive (but not exhaustive) list of specific behaviours – on which to hinge feedback.
Another simple acronym for remembering how to give effective feedback is the KSS (kiss) approach. It is particularly useful in the early stages of a student’s development. When giving feedback to the student, organise it in the following way: • • •
Keep doing what you are doing right (name the specific behaviour/s) Stop doing what you are doing incorrectly (name the specific unwanted/changeable behaviour/s) Start doing what you need to do to improve your performance (name specific desired behaviour)
Feedback that is effective will: • • • • • •
be expected by students; be ongoing – provided throughout the placement; be related to learning goals, standards and criteria set for the placement; include specific recommendations for improvement; be provided when the behaviour is still fresh in the student’s memory; relate to behaviours that are remediable;
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• • • • • • • • • • • •
deal with specific problems rather than generalisations; deal with decisions and actions rather than assumed intentions or interpretations; be based on information which is objective by first hand observations; be constructive and change-focused; start and end with positives, be encouraging; be sufficient – both often enough, and in enough detail; be focused on students performance, on their learning and on actions under their control, rather than on the students themselves or their characteristics; be timely in that it is received by students while it matters to them and in time for them to pay attention to further learning or receive further assistance; be appropriate to the purpose of the learning experience, and to the relevant criteria for success; be appropriate in relation to students understanding of what they are supposed to be doing; be received and understood by students; and be documented if appropriate and followed up at a later date.
Please remember that no matter how well you give feedback, individuals will react differently to your comments. This is explored in Managing the response to feedback section later in this module.
How do I provide feedback? Feedback can be provided in a number of ways and forms. It can be: • • • • • •
Written – notes written on student’s written work/report; Verbal; Non-verbal e.g. directing a position or hand movement; Formal/ informal – planned e.g. supervision session, or not planned e.g. in car on way home from home visit, over a lunch break; Direct/indirect – clear and explained vs. modelled ; and Self-reflective - asking students to evaluate themselves/ reflect on their performance initially, prior to giving your feedback.
You will use different methods of feedback on a daily basis. Sessions can be short and informal, for example, between appointments and based on one or two particular performance items; or planned and formal, covering the student’s performance generally, with specific areas for comment. The way you deliver your feedback will depend on what you have observed, where the student is in the placement, the time available and the learning style of the student. The majority of your feedback will be verbal; however you will be required to provide written feedback at times, for example at the final assessment. If you have more than one student, it is acceptable to have group feedback sessions. Group sessions can save time as often each student will have the same needs. Group sessions also allow the students to comment on each other’s performance. It is important to note how the students react to group sessions, as some students are reluctant to discuss personal performance concerns with other
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students. Group sessions will not replace individual sessions as negative and corrective feedback should always be given on an individual basis.
When do I provide feedback? When delivering feedback, it is important to ensure the student gets full advantage of the information, without feeling overwhelmed or incompetent. Basically, you will provide feedback whenever you see the need and the opportunity is available as well as during the evaluation of the student’s performance. Remember, feedback is most effective when given as soon as possible after the student is observed. You should plan certain times each week for formal feedback sessions as well. These might be short sessions, on a daily basis at first, for example immediately after lunch and at the end of the day, with longer sessions on a weekly basis, for example Friday afternoon to discuss the week. The structure of these sessions may change over the duration of the placement as the student gains experience and confidence. When providing feedback early in the placement the following guidelines may assist: • • • • •
Tell them what they get right and wrong; Provide regular feedback after performance; Encourage them to consider own performance but don’t test them Expect inconsistency; and ‘KSS/Kiss’ approach – keep doing, stop doing, start doing specific things.
However when providing feedback later in the placement you may want to utilise the following techniques: • • •
Ask them to tell you what they got right and wrong; Provide less feedback about outcome and more about quality; and Expect consistency and efficiency.
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Structuring feedback Because giving effective feedback is a skill, planning is essential to allow the student to get the most out of the feedback, and to ensure that you give the feedback effectively. When planning a feedback session, consider the following: •
What are you trying to address when giving the feedback?
•
What specific performance activities have you identified to correct or reinforce?
•
How might the student react to the feedback?
•
How will you manage any reactions?
The following process is an example of what you might do for a formal feedback sessions; however could be used in part, in other feedback settings: • • • • •
• • • •
Schedule a meeting time and place – try to ensure there will be no interruptions. Inform the student what will be discussed so that they can prepare. Start the meeting and discuss the content as planned. Allow the student to comment on their own performance Give appropriate feedback - Some advocate the value of using a ‘feedback sandwich’ when giving negative or critical feedback. This involves surrounding the negative with positive feedback, so that the person hears the more positive information at the beginning and end of the statement. Allow the student to comment on your feedback. Allow the student to give feedback on your performance. Develop a plan – identify issues and the strategies to use to improve and develop. Summarise the action to be taken and plan a time and place for the next meeting.
To develop your own skills in giving effective feedback it is important that you engage in reflection and self evaluation. After giving feedback, think about the following questions: • • • • • • • • •
Did you address the issues and performance as planned? How did you feel when giving the feedback? Did you focus on performance not the person, and did you use appropriate language? Do you feel you could have delivered the feedback more effectively? If so, how will you do it differently next time? How did the student react to the feedback? How did you handle their reaction? What was the outcome/action plan? Is there a need to contact the JCU Coordinator (for example if a student is at risk of failing?)
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Overcoming the challenges of giving feedback Most people report that giving feedback can be difficult. For example, you may have trouble finding the most appropriate words, or you don’t want to upset the receiver of the feedback especially when giving ‘negative’ feedback. It can be a source of anxiety to both the workplace educator as well as the student. Some concerns the workplace educator may have about giving or receiving feedback are: • • • • • •
It is time consuming; It is repetitious; It is difficult especially where performance is poor or a personal characteristic has to be addressed e.g. personal hygiene; They are concerned about causing tension in the supervisory relationship; They are concerned that they may not have evidence to back up the feedback; and They are concerned about the receiver’s reaction to the feedback.
The student may report that feedback is: • • • •
Unclear; Demoralising; Irrelevant; and/ or Untimely
To address these concerns you can try one or more of the following: • • • • •
Familiarise yourself/review the student’s learning outcomes and the assessment tool and frame your feedback around the set criteria and standards of the placement; Use strategies provided in this model to plan and structure your feedback e.g. use CORBS to plan what you have to say to ensure it is Clear, Owned, Regular, Balanced and Specific; Document any issues you have observed with enough information to allow the student to recall the event and give you the evidence to support your feedback; Discuss your concerns with a colleague and consider how you can improve; and Contact your JCU Coordinator and discuss your difficulty – they are happy to assist you.
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Feedback tips The table below lists some common pitfalls that workplace educators may fall into when giving feedback and suggests strategies of how to avoid these. Common pitfalls when giving feedback Generalised comments.
Personal comments, people orientated. Giving feedback too late after the fact.
Not formalised enough.
“Throw away” comments.
Providing negative feedback by listing only problems and areas of need. Not wanting to be the “bad guy” or do the “hard yards”. Disparity between feedback and assessment tool ratings, always giving positive feedback as it is easier, but reflecting the student’s true performance at evaluation by marking down. Avoid accusatory comments such as “you did this…”, “others have been complaining”. Overload the student with feedback on every issue. Offer feedback but seek no comments from student. Rely solely on reports from others. Surprise when the student gets upset with constructive feedback.
How to do better Specific targeted feedback – your comments should highlight specific events or examples rather than just general advice. It should also be specific about what the person did. (Avoid generalisations i.e. words such as ‘never’, ‘always’, ‘all’ etc) Comment on performance and behaviours that can be changed, rather than personality traits. Try to give the feedback as soon as the behaviour/task is observed, where possible, on a daily basis if required. Don’t wait till halfway or final assessment. Some feedback needs to be planned to allow the student to reflect on their performance without the need to rush off to their next task. Overtly flag your comments are “feedback” e.g. My key feedback is “…”. Deliver feedback face to face. Avoid giving casual or general comments that can be misconstrued as feedback and that student may take personally e.g. “you’re not yourself today; you’re not much good at that” Try to start and end with positives - Offer explicit suggestions for improvements and relate these to the goals, criteria and standards set for the placement. Stick to specific behaviours and remember that the student really wants to improve so they need more than positive/nice comments. Be honest with your formative feedback throughout the placement so that there are no surprises when delivering the evaluation and performance grades.
Own your comments by using “I” statements, include terms such as “I have evidenced” and “I have observed”. Target most important issues immediately and follow up on others in another session. Check understanding and willingness to accept the feedback – give the student time to think and respond, & provide action strategies. First hand observation is essential but can be supplemented by reports from others. Anticipate an emotional response: be supportive, ensure privacy, choose an appropriate time and enough time to give negative feedback. Have the contact details of JCU coordinator on hand. Let the student know that they can call JCU if desired; encourage them
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Feedback is requested by a family member or friend about the student’s progress.
to do so. Confidentiality must be maintained at all times and any contact by family or friends should be discussed with the student.
Managing the response to feedback Individual students will react differently to feedback given to them. No matter how skilled you are in delivering feedback, students may react in a variety of ways and not always positively. Students may: • • • • • •
question your comments; become upset/emotional; become angry; walk out of the interview; go to another team member looking for different feedback; and complain to a family member who may contact you to discuss your feedback.
Remember that it is important to address these issues immediately. Following are a number of options you can use to deal with any of these issues: • • • • • • • •
Contact your JCU Coordinator for support and advice; Discuss with work colleagues for support; Practise your communication skills; Allow time for the student to calm down; Address unprofessional behaviours; Continue to provide the feedback; Review the strategies and structure you used for giving feedback; and Refer the student/family member to JCU.
Summary Giving effective feedback to a student is one of the most important tools for enhancing their learning while on placement. Giving effective feedback is a skill that is developed over time and with practice. This module provides the workplace educator with a range of strategies and tools to assist them to become skilled in giving and receiving feedback. An example of a workplace educator providing feedback to a student is provided below. EXAMPLE: The student is quiet and you notice they are not speaking much in a team meeting and you need to continually prompt them to do this. Instead of saying “I think you lack confidence when speaking with other staff” you may say
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“I have observed during team meetings that you spoke only when it was your time to present. Your presentations are very well prepared, and you covered all the main issues relevant to the clients; however you only spoke when it was your turn. I would like you to show more initiative in team meetings so that you offer additional relevant information during client discussions at appropriate times. How do you think you might do this? (Give time for the student to respond). Let’s talk about a few ways that you can do this”.
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Refer to your responses to the exercise in the beginning of this module. Consider a situation where you will have to give feedback to a student and review the following questions: • • • • • •
What am I looking for? How will the student demonstrate this? How will I document observations for feedback e.g. a diary, notebook How will I deliver the feedback? How will I give ‘negative’ feedback? What if the student gets upset? How will I deal with receiving feedback from the student?
Have the questions posed been answered? Do you feel more comfortable about giving feedback?
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References Branch, W., & Paranjape, A. (2002). Feedback and reflection: Teaching methods for clinical settings. Academic Medicine, 77(12), 1185-1188. Delany, C., & Molloy, E. (Eds). (2009). Clinical education in the health professions. NSW Australia: Elsevier. Dowling, S. (2001). Supervision: Strategies for Successful Outcomes and Productivity. Massachusetts: Allyn & Bacon. Ellis, G. (2000). Reflective learning and supervision. In L. Cooper & L. Briggs (Eds.), Fieldwork in the human services: Theory and practice for field educators (pp 227 – 238). NSW: Allen and Unwin. Ende, J. (1983). Feedback in clinical medical education. The Journal of the American Medical Association, 250(6), 777-781. Garbutt, K., & Tanner, B. (2009). Occupational Therapy Supervisors Workshop (Level One). Presented at a JCU Supervisors Workshop in July 2009, Townsville. Garbutt, K., & Tanner, B. (2009). Students Experiencing Difficulty on Placement and/or at Risk of Failing Workshop. Presented at a JCU Supervisors Workshop in October, 2009, Townsville. Hawkins, P., & Shohet, R. (1989). Supervision in the helping professions. Buckingham: Open University Press. Luft, J. (1969). Of human interaction. Palo Alto, CA: National Press. Marriott, J., & Galbraith, K. (2005). Exploring the roles of the clinical educator. In M. Rose & D. Best (Eds.), Transforming practice through clinical education, professional supervision and mentoring (pp 60-68). Edinburgh: Elsevier Churchill Livingstone. Nagy, S., Mills, J., Waters, D., & Birks, M. (2010). Using research in healthcare practice. NSW: Lippincott Williams and Wilkins. Pellatt, A., & Barker, R. (2009). Supervisors Workshop. Workshop presented in July 2009, Townsville. Occupational Therapy Fieldwork Supervisor’s Manual. (2009-2010), James Cook University. Physiotherapy Clinical Education Supervisors Manual. (2009-2010), James Cook University. Price, M., & O’Donovan, B. (2006). Improving performance through enhancing student understanding criteria and feedback. In C. Bryan & K. Clegg (Eds.), Innovative assessment in higher education (pp. 100-109). London: Routledge. Queensland Occupational Therapy Fieldwork Collaborative (2007). The Clinical Educator’s Resource Kit. Retrieved May 2010 at http://www.qotfc.edu.au/resource/index.html Speech Pathology, Clinical Education Manual. (2010). James Cook University.
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Providing and receiving feedback is essential in the teaching and learning process. The provision of effective feedback can be one of the most important tools in facilitating student learning. As a workplace educator, you will be required to give feedback on a student’s performance while they are on placement at your workplace. It is likely that you will also receive feedback on your performance as a supervisor. Feedback can be given at any time and often occurs during informal or formal supervision and through the evaluation process. Giving feedback effectively is a skill, and like all skills, it takes practice to build confidence and competence. This module will explore the giving and receiving of effective feedback and the methods, timing and content of effective feedback. This module includes: • • • • • • • • • • • •
Introduction How feedback works: The Johari window model How is feedback different from evaluation? Strategies for effective feedback How do I provide feedback? When do I provide feedback? Structuring feedback Overcoming the challenges of giving feedback Feedback tips Managing the response to feedback Summary / Example References
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Introduction As discussed previously in the module, You as an Educator, providing feedback is an important role of the workplace educator. As an educator, your role in giving feedback is essential to allow the student to develop and gain the most from their placement. Giving feedback is the process we use to advise the student of our perceptions of their performance. Giving (and receiving) feedback is important for effective training and skill development. The feedback process tells students how others see them and helps them to identify strengths and areas for growth in professional competencies.
Observer
Feedback
Instructor Manager
Counsellor
Evaluator
Roles and Relationships of an Educator
(Adapted from Turney et al. (1982, cited in Best, 2005, p.48))
How feedback works: The Johari window model The Johari Window is a model developed by psychologists Joseph Luft and Harry Ingham to describe how humans interact, including the process of giving and receiving feedback (Luft, 1969). The model is used as a tool to foster self-awareness and understanding of group processes and interaction. The window is illustrated below and has four quadrants or panes. The Open pane is the part of ourselves that we see and others see. The Blind Spot is the aspect that others see but of which we are not aware. The Unknown is the unconscious or subconscious side of us, seen by neither ourselves nor others. The Hidden pane is our private space, which we know but keep from others.
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Known to others
Not known to others
Known to Self
Not known to self
OPEN
BLIND SPOT
HIDDEN
UNKNOWN
The Johari Window (Luft ,1969).
Receiving feedback enlarges the Open quadrant by reducing our ‘blind spot’. The receiver of the feedback learns things about themselves of which they were previously unaware. This applies to both the student and the educator. It is possible to increase the Open pane and reduce the Hidden pane through self disclosure. Sharing something of ourselves, previously unknown to the student, may assist in the development of trust. This is useful in developing a relationship with the student so they feel comfortable and safe and learning is enhanced. The module, Facilitating Student Learning, has more information about developing these aspects of the supervisory relationship.
Think about a time when you received feedback on your performance. • What was positive/ not positive about the situation? • What did you learn from the feedback about yourself?
How is feedback different from evaluation? Feedback and evaluation are crucial components of a student placement however it should be noted that they are different and serve different purposes. These are highlighted below. Feedback • • •
provides the student with objective information and insight about actual performance and how it relates to performance expectations, as well as the consequences of actions is formative and points the student in the direction of improving professional competency and moving toward goal achievement encourages reflective and self-evaluative practice
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Providing feedback serves a number of purposes. It can be either positive or constructive to: • • •
indicate the level of competence of the student; instruct to change/improve behaviour; and motivate a student’s desire to perform well.
Evaluation • •
is summative and presents an assessment about how well a student has performed and/or met a given goal or competency usually follows feedback and a period of effort at improving performance in identified skills or competencies, within a time-frame
(Ende, 1983; Branch & Paranjape, 2002)
Consider a situation where you will have to give feedback to a student & review the following questions: • What am I looking for? • How will the student demonstrate this? • How will I document observations for feedback e.g. a diary, notebook • How will I deliver the feedback? • How will I give ‘negative’ or constructive feedback? What if the student gets upset? • How will I deal with receiving feedback from the student? Document your answers to these questions and review them at the end of the module.
Strategies for Effective Feedback Price and O’Donovan (2006) suggest that effective feedback starts with a set of explicit criteria and standards that the student understands, and which form the basis for both feedback and evaluation. Students need to be encouraged to engage actively with these criteria and standards throughout their placement and with feedback provided by the workplace educator, other staff or other students. Students need to practice reflection to assist with their learning and development while on placement. Further information about reflective practice and activities to facilitate this can be found in the module, Facilitating Student Learning. Your goal as a workplace educator is to deliver feedback in a respectful and constructive manner, which will help the student learn and develop. For feedback to be helpful, it should be clear and specific and relate to the criteria and standards established at the commencement of the placement. When a negative comment or correction of a particular behaviour is necessary, clear justification for James Cook University Workplace Educator Program June 2011
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an alternative approach should be provided. The giver of the feedback should always check that the receiver has fully understood the points being made. An acronym to help remember how to give effective feedback is ‘CORBS’: Clear; Owned; Regular; Balanced; and Specific (Hawkins & Shohet, 1989). • •
•
•
•
Clear - try to be clear about what the feedback is that you want to give. Being vague and faltering will increase the anxiety in the receiver and may not be understood. Owned - The feedback you give is your own perception and not an ultimate truth. It therefore says as much about you as it does about the person who receives it. It helps the receiver if this is stated or implied in the feedback, e.g. “I found that …” rather than “It’s obvious that…” Regular - If the feedback is given regularly it is more likely to be useful. If this does not happen there is a danger that grievances are saved until they are delivered in one large package. Try to give the feedback as close to the event as possible and early enough for the person to do something about it, that is, do not wait until someone is leaving to tell them how they could have done the job better. Balanced - It is good to balance negative and positive feedback and if you find that the feedback you give to any individual is always either positive or negative, this probably means that your view is distorted in some way. This does not mean that each piece of critical feedback must always be accompanied by something positive but rather a balance should be created over time. Specific - Generalised feedback is hard to learn from. Phrases like, “You talk too much” can only lead to hurt and anger. “You talk too much to the client while you are administering an assessment” gives the receiver some information which he or she can choose to use or ignore. Physiotherapy provides Examples of Key Performance Indicators - a useful, comprehensive (but not exhaustive) list of specific behaviours – on which to hinge feedback.
Another simple acronym for remembering how to give effective feedback is the KSS (kiss) approach. It is particularly useful in the early stages of a student’s development. When giving feedback to the student, organise it in the following way: • • •
Keep doing what you are doing right (name the specific behaviour/s) Stop doing what you are doing incorrectly (name the specific unwanted/changeable behaviour/s) Start doing what you need to do to improve your performance (name specific desired behaviour)
Feedback that is effective will: • • • • • •
be expected by students; be ongoing – provided throughout the placement; be related to learning goals, standards and criteria set for the placement; include specific recommendations for improvement; be provided when the behaviour is still fresh in the student’s memory; relate to behaviours that are remediable;
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• • • • • • • • • • • •
deal with specific problems rather than generalisations; deal with decisions and actions rather than assumed intentions or interpretations; be based on information which is objective by first hand observations; be constructive and change-focused; start and end with positives, be encouraging; be sufficient – both often enough, and in enough detail; be focused on students performance, on their learning and on actions under their control, rather than on the students themselves or their characteristics; be timely in that it is received by students while it matters to them and in time for them to pay attention to further learning or receive further assistance; be appropriate to the purpose of the learning experience, and to the relevant criteria for success; be appropriate in relation to students understanding of what they are supposed to be doing; be received and understood by students; and be documented if appropriate and followed up at a later date.
Please remember that no matter how well you give feedback, individuals will react differently to your comments. This is explored in Managing the response to feedback section later in this module.
How do I provide feedback? Feedback can be provided in a number of ways and forms. It can be: • • • • • •
Written – notes written on student’s written work/report; Verbal; Non-verbal e.g. directing a position or hand movement; Formal/ informal – planned e.g. supervision session, or not planned e.g. in car on way home from home visit, over a lunch break; Direct/indirect – clear and explained vs. modelled ; and Self-reflective - asking students to evaluate themselves/ reflect on their performance initially, prior to giving your feedback.
You will use different methods of feedback on a daily basis. Sessions can be short and informal, for example, between appointments and based on one or two particular performance items; or planned and formal, covering the student’s performance generally, with specific areas for comment. The way you deliver your feedback will depend on what you have observed, where the student is in the placement, the time available and the learning style of the student. The majority of your feedback will be verbal; however you will be required to provide written feedback at times, for example at the final assessment. If you have more than one student, it is acceptable to have group feedback sessions. Group sessions can save time as often each student will have the same needs. Group sessions also allow the students to comment on each other’s performance. It is important to note how the students react to group sessions, as some students are reluctant to discuss personal performance concerns with other
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students. Group sessions will not replace individual sessions as negative and corrective feedback should always be given on an individual basis.
When do I provide feedback? When delivering feedback, it is important to ensure the student gets full advantage of the information, without feeling overwhelmed or incompetent. Basically, you will provide feedback whenever you see the need and the opportunity is available as well as during the evaluation of the student’s performance. Remember, feedback is most effective when given as soon as possible after the student is observed. You should plan certain times each week for formal feedback sessions as well. These might be short sessions, on a daily basis at first, for example immediately after lunch and at the end of the day, with longer sessions on a weekly basis, for example Friday afternoon to discuss the week. The structure of these sessions may change over the duration of the placement as the student gains experience and confidence. When providing feedback early in the placement the following guidelines may assist: • • • • •
Tell them what they get right and wrong; Provide regular feedback after performance; Encourage them to consider own performance but don’t test them Expect inconsistency; and ‘KSS/Kiss’ approach – keep doing, stop doing, start doing specific things.
However when providing feedback later in the placement you may want to utilise the following techniques: • • •
Ask them to tell you what they got right and wrong; Provide less feedback about outcome and more about quality; and Expect consistency and efficiency.
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Structuring feedback Because giving effective feedback is a skill, planning is essential to allow the student to get the most out of the feedback, and to ensure that you give the feedback effectively. When planning a feedback session, consider the following: •
What are you trying to address when giving the feedback?
•
What specific performance activities have you identified to correct or reinforce?
•
How might the student react to the feedback?
•
How will you manage any reactions?
The following process is an example of what you might do for a formal feedback sessions; however could be used in part, in other feedback settings: • • • • •
• • • •
Schedule a meeting time and place – try to ensure there will be no interruptions. Inform the student what will be discussed so that they can prepare. Start the meeting and discuss the content as planned. Allow the student to comment on their own performance Give appropriate feedback - Some advocate the value of using a ‘feedback sandwich’ when giving negative or critical feedback. This involves surrounding the negative with positive feedback, so that the person hears the more positive information at the beginning and end of the statement. Allow the student to comment on your feedback. Allow the student to give feedback on your performance. Develop a plan – identify issues and the strategies to use to improve and develop. Summarise the action to be taken and plan a time and place for the next meeting.
To develop your own skills in giving effective feedback it is important that you engage in reflection and self evaluation. After giving feedback, think about the following questions: • • • • • • • • •
Did you address the issues and performance as planned? How did you feel when giving the feedback? Did you focus on performance not the person, and did you use appropriate language? Do you feel you could have delivered the feedback more effectively? If so, how will you do it differently next time? How did the student react to the feedback? How did you handle their reaction? What was the outcome/action plan? Is there a need to contact the JCU Coordinator (for example if a student is at risk of failing?)
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Overcoming the challenges of giving feedback Most people report that giving feedback can be difficult. For example, you may have trouble finding the most appropriate words, or you don’t want to upset the receiver of the feedback especially when giving ‘negative’ feedback. It can be a source of anxiety to both the workplace educator as well as the student. Some concerns the workplace educator may have about giving or receiving feedback are: • • • • • •
It is time consuming; It is repetitious; It is difficult especially where performance is poor or a personal characteristic has to be addressed e.g. personal hygiene; They are concerned about causing tension in the supervisory relationship; They are concerned that they may not have evidence to back up the feedback; and They are concerned about the receiver’s reaction to the feedback.
The student may report that feedback is: • • • •
Unclear; Demoralising; Irrelevant; and/ or Untimely
To address these concerns you can try one or more of the following: • • • • •
Familiarise yourself/review the student’s learning outcomes and the assessment tool and frame your feedback around the set criteria and standards of the placement; Use strategies provided in this model to plan and structure your feedback e.g. use CORBS to plan what you have to say to ensure it is Clear, Owned, Regular, Balanced and Specific; Document any issues you have observed with enough information to allow the student to recall the event and give you the evidence to support your feedback; Discuss your concerns with a colleague and consider how you can improve; and Contact your JCU Coordinator and discuss your difficulty – they are happy to assist you.
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Feedback tips The table below lists some common pitfalls that workplace educators may fall into when giving feedback and suggests strategies of how to avoid these. Common pitfalls when giving feedback Generalised comments.
Personal comments, people orientated. Giving feedback too late after the fact.
Not formalised enough.
“Throw away” comments.
Providing negative feedback by listing only problems and areas of need. Not wanting to be the “bad guy” or do the “hard yards”. Disparity between feedback and assessment tool ratings, always giving positive feedback as it is easier, but reflecting the student’s true performance at evaluation by marking down. Avoid accusatory comments such as “you did this…”, “others have been complaining”. Overload the student with feedback on every issue. Offer feedback but seek no comments from student. Rely solely on reports from others. Surprise when the student gets upset with constructive feedback.
How to do better Specific targeted feedback – your comments should highlight specific events or examples rather than just general advice. It should also be specific about what the person did. (Avoid generalisations i.e. words such as ‘never’, ‘always’, ‘all’ etc) Comment on performance and behaviours that can be changed, rather than personality traits. Try to give the feedback as soon as the behaviour/task is observed, where possible, on a daily basis if required. Don’t wait till halfway or final assessment. Some feedback needs to be planned to allow the student to reflect on their performance without the need to rush off to their next task. Overtly flag your comments are “feedback” e.g. My key feedback is “…”. Deliver feedback face to face. Avoid giving casual or general comments that can be misconstrued as feedback and that student may take personally e.g. “you’re not yourself today; you’re not much good at that” Try to start and end with positives - Offer explicit suggestions for improvements and relate these to the goals, criteria and standards set for the placement. Stick to specific behaviours and remember that the student really wants to improve so they need more than positive/nice comments. Be honest with your formative feedback throughout the placement so that there are no surprises when delivering the evaluation and performance grades.
Own your comments by using “I” statements, include terms such as “I have evidenced” and “I have observed”. Target most important issues immediately and follow up on others in another session. Check understanding and willingness to accept the feedback – give the student time to think and respond, & provide action strategies. First hand observation is essential but can be supplemented by reports from others. Anticipate an emotional response: be supportive, ensure privacy, choose an appropriate time and enough time to give negative feedback. Have the contact details of JCU coordinator on hand. Let the student know that they can call JCU if desired; encourage them
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Feedback is requested by a family member or friend about the student’s progress.
to do so. Confidentiality must be maintained at all times and any contact by family or friends should be discussed with the student.
Managing the response to feedback Individual students will react differently to feedback given to them. No matter how skilled you are in delivering feedback, students may react in a variety of ways and not always positively. Students may: • • • • • •
question your comments; become upset/emotional; become angry; walk out of the interview; go to another team member looking for different feedback; and complain to a family member who may contact you to discuss your feedback.
Remember that it is important to address these issues immediately. Following are a number of options you can use to deal with any of these issues: • • • • • • • •
Contact your JCU Coordinator for support and advice; Discuss with work colleagues for support; Practise your communication skills; Allow time for the student to calm down; Address unprofessional behaviours; Continue to provide the feedback; Review the strategies and structure you used for giving feedback; and Refer the student/family member to JCU.
Summary Giving effective feedback to a student is one of the most important tools for enhancing their learning while on placement. Giving effective feedback is a skill that is developed over time and with practice. This module provides the workplace educator with a range of strategies and tools to assist them to become skilled in giving and receiving feedback. An example of a workplace educator providing feedback to a student is provided below. EXAMPLE: The student is quiet and you notice they are not speaking much in a team meeting and you need to continually prompt them to do this. Instead of saying “I think you lack confidence when speaking with other staff” you may say
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“I have observed during team meetings that you spoke only when it was your time to present. Your presentations are very well prepared, and you covered all the main issues relevant to the clients; however you only spoke when it was your turn. I would like you to show more initiative in team meetings so that you offer additional relevant information during client discussions at appropriate times. How do you think you might do this? (Give time for the student to respond). Let’s talk about a few ways that you can do this”.
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Refer to your responses to the exercise in the beginning of this module. Consider a situation where you will have to give feedback to a student and review the following questions: • • • • • •
What am I looking for? How will the student demonstrate this? How will I document observations for feedback e.g. a diary, notebook How will I deliver the feedback? How will I give ‘negative’ feedback? What if the student gets upset? How will I deal with receiving feedback from the student?
Have the questions posed been answered? Do you feel more comfortable about giving feedback?
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References Branch, W., & Paranjape, A. (2002). Feedback and reflection: Teaching methods for clinical settings. Academic Medicine, 77(12), 1185-1188. Delany, C., & Molloy, E. (Eds). (2009). Clinical education in the health professions. NSW Australia: Elsevier. Dowling, S. (2001). Supervision: Strategies for Successful Outcomes and Productivity. Massachusetts: Allyn & Bacon. Ellis, G. (2000). Reflective learning and supervision. In L. Cooper & L. Briggs (Eds.), Fieldwork in the human services: Theory and practice for field educators (pp 227 – 238). NSW: Allen and Unwin. Ende, J. (1983). Feedback in clinical medical education. The Journal of the American Medical Association, 250(6), 777-781. Garbutt, K., & Tanner, B. (2009). Occupational Therapy Supervisors Workshop (Level One). Presented at a JCU Supervisors Workshop in July 2009, Townsville. Garbutt, K., & Tanner, B. (2009). Students Experiencing Difficulty on Placement and/or at Risk of Failing Workshop. Presented at a JCU Supervisors Workshop in October, 2009, Townsville. Hawkins, P., & Shohet, R. (1989). Supervision in the helping professions. Buckingham: Open University Press. Luft, J. (1969). Of human interaction. Palo Alto, CA: National Press. Marriott, J., & Galbraith, K. (2005). Exploring the roles of the clinical educator. In M. Rose & D. Best (Eds.), Transforming practice through clinical education, professional supervision and mentoring (pp 60-68). Edinburgh: Elsevier Churchill Livingstone. Nagy, S., Mills, J., Waters, D., & Birks, M. (2010). Using research in healthcare practice. NSW: Lippincott Williams and Wilkins. Pellatt, A., & Barker, R. (2009). Supervisors Workshop. Workshop presented in July 2009, Townsville. Occupational Therapy Fieldwork Supervisor’s Manual. (2009-2010), James Cook University. Physiotherapy Clinical Education Supervisors Manual. (2009-2010), James Cook University. Price, M., & O’Donovan, B. (2006). Improving performance through enhancing student understanding criteria and feedback. In C. Bryan & K. Clegg (Eds.), Innovative assessment in higher education (pp. 100-109). London: Routledge. Queensland Occupational Therapy Fieldwork Collaborative (2007). The Clinical Educator’s Resource Kit. Retrieved May 2010 at http://www.qotfc.edu.au/resource/index.html Speech Pathology, Clinical Education Manual. (2010). James Cook University.
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