More on feedback

Following up from the crap sandwich discussion, I had a vague recollection of being taught something about peer feedback and how to make negative feedback as palatable as possible.

And... after spending far too much time going through old lecture notes and searching using Google, I found this* short document based on published work. This document gives guidance on how the nature of feedback affects motivation and also recommends not beating about the bush when it comes to providing feedback - so no crap sangers, please.

I particularly like the "Recognition Grid" which has stuck in my mind since I first came across it almost ten years ago:

Type of feedback / Effect on motivation (in what seems to be arbitrary units)
Generalised positive +100
Specific positive +50
Specific negative –200
Generalised negative –1,000

The point here being that generalised feedback applies to character traits, behaviours and other impossible to change aspects of an individual whereas specific relates to a particular action taken by that individual.

Thus, "I like working with you" is great to hear: I must be a stand-up guy! Compared with "You are terrible to work with"... what is it, do I have bad breath or something and if I do how do I change that?

Final point: negative feedback is remembered for much longer than positive... the taste of crap kinda lingers, a much more potent flavour than sliced white bread.

Reference: Carlopio, J., Andrewartha, G. & Armstrong, H. 2005. Developing management skills: a comprehensive guide for leaders. 3rd edn. Longmans, Australia. 409–410.


*For some reason Blogger is attaching some extraneous text in front of the ANU link. Remove the clearly wrong text if you want to see the file.

Crap sandwiches

Thinking through the last post, I realised I'd put up some received wisdom on the good old hamburger approach to providing feedback without backing it up with facts. In the spirit of evidence based medicine, to discover whether the crap sandwich is as crap as I thought, or not, I did a quick scout around to see what the world's great thinkers in feedback provision are saying. Caveat: very quick scout about.

A group called Success Strategies, who look like they are a group of management consultants of some kind, post an interesting discussion on the method. Their key issues are that:

(i) most people know about this method, brace themselves for the crap in the middle and discount / ignore the rest, and
(ii) it only takes a couple of rides on the crap sandwich rollercoaster to learn exactly how it works and react as for (i).

This page also provides an alternate method which avoids direct criticism and instead kicks the discussion off with suggestions of how to deal with the situation which went awry. Interesting.

Although this approach is grounded in NLP, which some consider pseudoscience (it says here - although it seems to work for Derren Brown), this group have worked with some creditable organisations which provides a degree of weight to their work.

A literature search brings up little on the subject... perhaps a fruitful research topic for someone, who knows. The search did, however, bring up an excellent article from a US Obs&Gynae educational committee of some sort describing in detail how the US is approaching the provision of feedback to medical undergrads. They outline a quite structured, complex process which necessitates a dialogue and a lot of preparation with no input from peers... quite the opposite to what Australian med schools seem be recommending. Given the lack of outcome evidence (from what I can see), who knows which approach is best.

The reference for this, should anyone be interested, is: American Journal of Obstetrics and Gynecology (2007). 196 (6). 508 -513. I think it may be available if you register, but it's an Elsevier journal so perhaps not.

On balance, I would still say the crap sandwich is on the nose. Avoid.

Med Student peer review

As part of a new phalanx of insight-laden medical students, full of reflective goodness, we receive a lot of feedback from our betters / tutors / call them what you will on a broad range of elements of performance.

Further, given all the reflective bits and bobs, we are at the pointy end of plenty of feedback from ourselves too.

All of this is assessed, and, presumably, if it looks like we're lacking in insight or something, steps will be taken remedy matters before graduation.

On top of this, joy of joys, we are subject to feedback from our peers. We are monitored to make sure that we're not too soft on one another, presumably to avoid an eBay-feedbackesque situation where everyone is nice to avoid tit-for-tat retributions and so to ensure that the feedback is honest and, therefore, valuable.

This all sounds fair enough: most jobs in the real world require an annual or semi-annual appraisal which may or may not be 360 degrees in nature. However, normally the blow of receiving this feedback is softened by (i) the medium of delivery and (ii) who is providing the feedback. And perhaps you'll get a pay rise or a promo if the review goes well.

To address the second issue first, it's going to be interesting to see how the feedback from fellow students evolves over the rest of the course given that to date for most people I've spoken to it's been somewhat lacking in positive, actionable steps.

This isn't a huge surprise given that my peers don't have a lot of experience here and have only been taught the largely discredited "crap sandwich" approach to feedback (start with something good about you, then get the meat of the feedback with something crap about you, then finish off with what to do to improve). Still, some of the stuff is useful so I suck it in and take what I can from what I'm given.

The main issue is the first: the medium of delivery. In my colourful pre-med career I received diverse feedback from diverse people in diverse situations. I've had good reviews from balls-out US investment bankers in the backs of a taxis (mental image unintended), terrible pay news from nervous European bankers over telephone lines and woolly, "what was that conversation all about" feedback from fuddled academics in labs who weren't at all keen on this type of thing. I've also had to use a number of electronic systems having nominated a number of colleagues all of whom, and this is important, have been trained in using these systems the output of which is numerical.

However, what I haven't had is an online posting system where you log in and read feedback. I'm not sure about this route to provide feedback to happy recipients: there's not a lot of room for discussion / clarification with the feedbacker, there isn't space for emotional or intonational nuances to be provided: it's rather like getting a very personal SMS from someone you barely know.

Let's see how things progress.