Dr. El

Whether coaching supervisors on leadership skills or teaching employees to follow proper infection control procedures, the way in which feedback is offered can have an enormous impact on how it’s received and whether it’s implemented. 

In “Constructive criticism that works,” author Heather Stringer outlines psychological techniques that “increase the odds that feedback will lead to change.” Many of the ideas presented in the article can be easily adapted to a long-term care setting.

Type of feedback

One important distinction is between “evaluative feedback,” which comments on already-completed tasks, and “directive feedback,” which focuses on improvements to be made in the future. Studies show that people often have difficulty understanding how to use evaluative feedback to improve future efforts. 

To combat this, it’s suggested that conversations include a way to incorporate the comments being given. For instance, if a nursing supervisor is offered the criticism that they’d failed to tell a nurse some important information, the criticism will be more constructive if there’s discussion beyond “do this next time.”

More helpful would be a nonconfrontational exploration of why the information wasn’t delivered in the first place and a consideration of how to overcome the problem. The communication glitch could be because of a personal issue (prior conflict between the staff members, lack of organization skills, difficulty managing an intimidating personality, etc.), a practical obstacle (such as an emergency on the unit), or a systems problem (no direct means of contacting staff members, time pressures or burnout related to understaffing, etc.). Each obstacle requires a different solution or work-around to alter future handling of similar situations. 

Emotional environment

Another aspect of effective feedback considers the emotional environment in which it’s offered. According to industrial and organizational psychologist Lisa Steelman, PhD, a researcher Stringer consulted, “leaders in a supportive environment for feedback had much better performance improvement over time than those in the unsupportive feedback environment.”

Creating a supportive environment can include simple but thoughtful tweaks. For example, a department head who’s rushing from place to place in a hurried fashion creates a very different tone than one who’s walking more slowly and making eye contact with staff or one who has open office hours that allow for discussion. 

Other techniques to promote an encouraging atmosphere include checking back with workers in the days following feedback to see how it’s going and being open to workers questioning the feedback to make sure it’s relevant and understood. For instance, a supervisor could ask, “If you did it this way in the future, would this address all your concerns or is there something I’m missing?”

Challenges of offering criticism

Studies also show that people high in empathy (the kind of people who work in long-term care) can find it distressing to criticize others. The fix for this lies in practicing how to offer feedback, doing it frequently enough that some of the sting dissipates, and planning time afterwards to recuperate rather than, say, heading into an important meeting.

To combat bias in providing feedback, researchers suggest keeping a written log of issues to be discussed in conversations with all reporting employees and updating the log as needed. To avoid blindsiding workers with a negative review, the recommendation is to regularly schedule collaborative discussion sessions.

A benefit of kindness

As one would expect, fundamental to effective feedback is offering it with kindness. Not only does it create a more pleasant work environment, but it can also generate far more helpful information than one in which workers feel on the defensive.

Asking a staff member with gentle curiosity why they’re completing a task in an unexpected fashion, or not completing it at all, can illuminate a wide variety of problems. An aide who isn’t getting beds made on time might explain that it’s because there aren’t enough sheets, which might be due to an issue with the supply clerk, the linen company, the resident who’s hoarding sheets in her closet or any number of other possibilities, none of which could have been discovered and corrected without that gentle approach. 

The bottom line

The reality is that most of us give some sort of feedback to others quite frequently, whether it’s those we supervise, those we’re partnered with, or those we raise. Improving our ability to successfully navigate these discussions can help us in many arenas in life.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition and a Gold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements, visit her at EleanorFeldmanBarbera.com.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.