A few weeks ago I ran the Sheffield Half Marathon for the fourth time. I was wearing my Iron Man compression gear for the event and right from the start it meant I got extra shouts from the people lining the streets, ‘Come on Iron Man! You can do it!’ and parents shouting to their kids, ‘Look, there’s Iron Man!’ with subsequently delivered low down high-fives. There were even a few cheeky remarks about my glutes!!! However, there was also one bloke, near the start, who clearly wasn’t impressed with my attire: ‘For goodness sake mate, put it away!’ was his opinion. I spent a lot of time thinking about that comment on the run and after the race, I wonder if I should wear that outfit next year.
Respecting Positive Feedback
Recently I’ve been reflecting on the personal feedback that we receive as clinicians, specifically in formal multi-source feedback tools but also in general and wondering: ‘Do we show positive feedback the respect it deserves?’
As an Educational Supervisor I often go through multi source feedback results with junior doctors. I would guess that upwards of 95% of it is positive and yet it is the less than 5% that would be thought of as negative that we seem to spend most of our time talking about. The trainee and I have usually scanned through the comments in advance, subconsciously noting the positive words (keen, helpful, legible, conscientious, respect etc) but in reality skimming over them looking for the negative (late, disorganised, angry, arrogant, dismissive). If something negative is found, we talk about the issue raised, what actually happened, the learning opportunity and whether there is a reflection recorded somewhere in their portfolio about this feedback. In contrast, if nothing negative is found, there will be a generic, ‘Well done, that’s really good feedback, you should be pleased’ comment, perhaps a positive statement of my own to support it, and then we move swiftly on to the next topic.
Now, maybe it is just me but I think this is a common scenario and I’m become convinced it is not only unhelpful, it is downright disrespectful.
Firstly I think it is unhelpful because it potentially sends a message that all we, as supervisors and senior clinicians, are concerned about is when you behave badly, not when you behave well. At a systems level we are beginning to turn that ship around: Awesome and Amazing meetings and ‘DATIX’ forms for good outcomes are starting to happen, trying to turn us from a culture worried about making mistakes into learning from success but do we do that at an individual level? Surely we want to encourage and support lively, confident, engaging colleagues with their own unique personalities so we can have a stimulating, vibrant, eclectic workplace, but that will not happen if juniors are constantly second guessing themselves in a desperate, and ultimately impossible, attempt to please all of the people all of the time. Concentrating on occasional negative interactions runs the risk of training their personality out of them whilst we are trying to train medicine in to them!
Most of the spectators at public running events want to see people in different costumes, not a parade of runners in the same running top and shorts and I think we want something similar in medicine. Let’s celebrate the fact that most people are great to have around, that their different personalities are a richness we need in our working lives and encourage them to be themselves as much as possible.
Secondly, I think it is enormously disrespectful to the people who take the time to give positive feedback. My contention is that good positive feedback takes more effort to supply than negative feedback, for a number of reasons. For instance, over time we’ve not only become conditioned to spot errors and identify poor practice but we also feel the negative impact of that specific poor behaviour more acutely meaning it stays with us, ready to be recalled when required. Positive behaviours, on the other hand, are often more general, getting lost amongst the ‘noise’ of everyday life because, if we are honest, most people are actually behaving well most of the time! Thus when we try to give good positive feedback we have to stop and really think about someone if we are to do them any justice.
The other consideration with positive feedback compared to negative is that there is less of a potential for it to have a self serving element. When we give negative feedback there is often an element of us desiring a change in that individual which will make our lives better. We might hope that they will behave better within a team, work more effectively or just turn up to work on time! Whatever it is, we often want things to change to match our desires, the giver of the feedback may be the main beneficiary rather than the receiver. Those who give positive feedback, however, are focusing on the receiver, the giver gets little for their efforts, nothing new, it is altogether a more altruistic behaviour. They are like the people who show up on the streets to cheer at running events, standing for hours to clap people on and shout encouragement, with nothing more to gain than the enjoyment of seeing others succeed. I think we need to show positive feedback, or more correctly the people who take the time to give it, the respect they deserve.
So what does this mean for me then?
Firstly, as a supervisor I take time to read the positive feedback on trainees more carefully and ensure my trainee does too. We spend time talking about why it is positive, what attitudes and behaviours it helps reveal and how they can be maintained and nurtured. I also ask the trainee to go away and read over it again in a few weeks’ time, enjoy the good things that have been said about them and then write a reflection in their portfolio about it. I ask them to respect the people who gave the feedback by really taking it to heart.
Secondly, I need to heed my own advice. Having been through a journey with much negative feedback, I am aware that it was spending time with old positive feedback that helped me realise I wasn’t finished and newly obtained positive feedback that gave me confidence in my return to work. Even now, when I falter and my own self confidence struggles to recover from an isolated negative comment, I need to listen to the more frequent positive feedback people have made the effort to give and gain strength from that to keep moving forward.
Finally, despite what that one guy said about my clothing, to ignore all the positive feedback I got during the Sheffield Half Marathon and to concentrate on his one negative comment would be disrespectful to those who cheered me on, I’m not going to do that, Iron Man will be back in 2018!
Just to be clear, I do believe negative feedback needs to be respected as well. When I first put on my Iron Man gear my wife gave some very clear, helpful feedback which strongly suggested I wear running shorts underneath it. I respected that feedback too!