the trainee in difficulty: breaking the bad news dr val bythell programme director northern schools/...
Post on 22-Dec-2015
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The trainee in difficulty:Breaking the bad news
Dr Val Bythell
Programme director
Northern Schools/
Northern Deanerty
All feedback is ‘good’
Feedback that is thought / intended to be ‘good’ may not be perceived as such by the trainee if poorly given
Negative feedback may bring out into the open longstanding difficulties that the trainee is aware of and wants help with
‘Feedback is the breakfast of champions’
Why is the trainee in difficulty?
Trainees don’t want to perform poorly…. Sickness Social circumstances Inadequate training Lacking ability
What inhibits feedback?
Failure to observe Fear of - emotional response
- reduction of teacher’s popularity
- harm to student’s self-image
Often justified as ‘the circumstances aren’t appropriate’, ‘I don’t have time’ or ‘its not my job’
Consequences of inadequate feedback
Trainee is ‘adrift’, without direction More susceptible to negative body language May develop false standards, arrogance May develop paralysis, fear Becomes dependent on summative feedback,
exams Loses opportunity to improve (eg moves to
another post)
What type of information do you have?
Hearsay / gossip Direct report - verbal,written Directly observed performance Concrete outcome data Sickness / absence data Trainee’s self-reported difficulties
What do you need to do?
Consider risk management / patient safety issues
Obtain as much specific information about the perceived difficulties, and about perceived good behaviour, as possible
Arrange a feedback / appraisal meeting with the trainee ASAP - appropriate setting etc
Effective feedback - ‘Do’s’
Prepare Maintain respect, empathy Begin with open questions Listen Limit feedback to remediable behaviour Be specific about both ‘good’ and ‘bad’
behaviour Check understanding
Remediable behaviour vs. inferred...
‘You are often late for lists’ is better than
‘Your time-keeping is poor’
‘I have some difficulty in understanding what you are saying’ is better than
‘You don’t communicate well’
Possible causes of frequently being late...
Not adequately informed re. time to attend long/difficult journey caring for dependents illness - eg drug dependency, depression awareness that things are going badly etc etc
Giving feedback
Ask the trainee to tell you how things are going first
What is going well with your training?
What aspects could you improve?
Effective feedback - ‘Don’ts’
Don’t use indirect / inferred statements Don’t let fear prevent you from giving
negative feedback Don’t be generally supportive then
specifically critical Don’t discuss innate characteristics or
attitudes, only actions
Receiving feedback
Listen Check understanding Try not to be defensive Thank the giver for the feedback
If the feedback is not skillfully given & received...
Defensive behaviour - ‘shoot the messenger’, Blames others and circumstances Basic message is not heard
If feedback is successfully given...
Together with the trainee (and others) Formulate goals/objectives Decide on how best to achieve those goals
In summary
Don’t avoid giving ‘negative’ feedback
Always give specific positive feedback first
Comment on behaviour, not core characteristics
It will not be as bad as you think it will!