Tips for delivering feedback based on brain science

Giving staff feedback can strike fear in the heart of many practice managers. It’s uncomfortable. For some, it feels confrontational.

Which is probably why Gallup data show that nearly half (47 percent) of employees say they received feedback from their manager "a few times or less" in the past year.¹

With a bit of insight from brain research and a little practice, managers of any experience level can make feedback conversations more comfortable. If your goal is to support staff learning and improve performance, here are 4 tips that can help you get it right.

1. Make it frequent, short, and specific.

More than 50 percent of Millennials and nearly 40 percent of non-Millennials prefer receiving feedback monthly. And nearly 20 percent of Millennials say they’d like feedback weekly. In this same study, Millennials said that their number one source of development is their manager, but only 46 percent say they are getting the feedback they need from him or her.²

Don’t wait until the annual performance appraisal; make feedback an ongoing conversation. The discussions can be as short as five minutes - as long as you focus on specifics.

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For example, instead of, “great job!” you might try, “I heard you diffusing that patient’s anger when we ran 40 minutes late. You did a great job staying calm and explaining the situation.” 

And if the feedback is a learning opportunity, think like a coach: Let them know what they are doing well, and how that impacts the outcome on their productivity, the patient experience, etc. Then, teach by asking questions that ignite insight and learning. 

For instance, instead of, “I heard you talking with that patient about her bill. Here’s a better way…,” you might try, “I heard you talking with that patient about her bill. You stayed very composed. Why do you think she got upset? What might you do differently next time?”
 

2. Build on existing skills instead of delivering “constructive criticism.”

Research indicates a rather shocking truth when you consider how long managers have been delivering constructive criticism to employees. Not only does telling people how to improve keep them from exceling and thriving, it actually hinders learning and growth.³

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Neurologically, we grow more in our areas of greater ability. Science shows that our brains grow far more neurons and synaptic connections in places where they already have the most neurons and synaptic connections. In other words, people learn when they recognize how they might improve on something they already know and understand. Thus, it’s more effective to capitalize on what staff do well and grow their skills from that place of strength.⁴ 

I remember a practice manager who was quite introverted. She didn’t do well at training or developing the staff, but she excelled at data analysis. Instead of using “constructive criticism” to improve the manager's training and relationship management skills, we stepped up her authority over financial and report analysis. We also moved hiring, training, and onboarding to a supervisor with a workstyle better suited to these tasks.

You can’t build up staff from a place of weakness. Leverage and build on staff strengths instead of trying to develop skills they have limited aptitude for.

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3. Watch your word choices.

“Can I give you some feedback?” immediately puts staff on guard and makes them defensive. From a physiological standpoint, the brain responds to this type of feedback as a threat, triggering what’s commonly referred to as “fight or flight” behaviors, which limits the brain’s ability to learn. 

And avoid words and phrases like ‘you should’ and ‘you need to…’ 

Instead, frame statements and questions in the first-person; use “I” and “my” instead of “you.” It takes the focus off the employee and provides an opportunity for a productive conversation to unfold. Some examples:

Not This

This

You should do this...

Here’s what I would do/how I would handle it.

Here’s what you need to do to improve your status reports to the physicians.

When I’ve been in this situation, I’ve found these things work best for me, because...

You need to be more organized.                    

When I see you getting stressed about the paper on your desk, and the patient calls you have to return, I get concerned you may be taking on too much.

What you are doing at the front desk is not working.

I had a similar thing happen and here’s what I did that might work for you...

_{Contributing source: The Feedback Fallacy, Marcus Buckingham, Ashley Goodall, Harvard Business Review, March–April 2019 Issue, https://hbr.org/2019/03/the-feedback-fallacy}

4. Recognize the difference between delivering instructional feedback vs. performance feedback.

Instructional feedback is fact-based. For example, correcting a billing team employee who is not following the practice’s procedure for denial management. Or, telling a medical assistant that he or she has been incorrectly completing forms for the outside lab. Correcting how an employee performs specific tasks is useful and straightforward. Think of it as a form of refresher training that ensures tasks and procedures are followed.

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Performance feedback is subjective. Telling people what we think of their productivity, supervisory skills, or problem-solving abilities is a stickier discussion. With performance feedback there are no fact-based measures to rate or assess. (Appraisal rating scales are a form of subjective scoring.) Further, data show that 61% of how you rate the staff is actually a reflection of your own characteristics, not theirs. In other words, how you rate the potential of employees is based more on how you define good performance than who the employee is or what they are capable of. This is called the Idiosyncratic Rater Effect. 

Delivering performance feedback is more challenging and takes some practice. Don't beat yourself up if it's uncomfortable at first. Learn from each conversation and have the self-awareness to continuously improve.

Cheryl Toth, MBA works with KarenZupko & Associates, Inc. delivering management coaching and professional development services.

References:

It's the Manager, Jim Clifton, Jim Harter, 2019, p 80.

Millennials Want to Be Coached at Work, Harvard Business Review, Karie Willyerd, February 27, 2015. https://hbr.org/2015/02/millennials-want-to-be-coached-at-work

The Feedback Fallacy, Harvard Business Review,Marcus Buckingham, Ashley Goodall, March–April 2019, https://hbr.org/2019/03/the-feedback-fallacy

Ibid.