Tool: Formative Feedback
While feedback in general can be verbal or nonverbal and intentional or unintentional, formative feedback is information deliberately provided to improve team performance. The ability to communicate self-improvement information in a useful way is an important skill in the team improvement process. Any team member can give formative feedback at any time; it is not limited to team leaders or formal evaluation mechanisms.
Several types of feedback can both provide or undermine mutual support in your teams. These include:
- Formal:
- Is retrospective and typically scheduled in advance
- Has an evaluative quality
- Examples: collaborative discussions, case conferences, individual performance reviews
- Informal:
- Typically given in real time
- Provided on an ongoing basis
- Focuses on development of knowledge and practical skills
- Examples: huddles, debriefs
Examples of effective feedback include:
- Cautioning team members about potentially unsafe situations: "The resident reported feeling dizzy and weak this morning. Do you think we should mention this to her daughter when she visits this afternoon?"
- Providing necessary information: "Did you know that the patient saw her pulmonologist last week? There's no report in the chart. I’ll contact the pulmonary office and ask them to send us the report."
- Providing encouragement: "Thank you for taking the extra time to explain the side effects of my new medicine. Now I'll know what to watch for when I start taking it."
Effective feedback benefits the team in several ways, including:
- Fostering improvement in work performance.
- Meeting the team's and individuals' need for growth.
- Promoting better working relationships.
- Helping the team set goals for ongoing improvement.
- Ensuring patients are actively engaged in care decisions and treatment.
Positive feedback should also be provided to team members to reinforce positive behaviors. All of us benefit from knowing that we've done a good job and that others have recognized it. Providing feedback acknowledging a job well done will also communicate to people that they are valued and viewed as an important part of the team.
Unintended or nonverbal feedback may either enhance or undermine team performance. If a team member says to "take your time" but their body language reflects frustration and impatience, the nonverbal message will be perceived as the real one. Conversely, if a person puts their phone in their pocket, asks the other person to sit down so the two of them can talk, and then provides feedback, that feedback is more likely to be viewed as well intentioned and designed to help the person receiving it.
Effective and affirming formative feedback can be provided at any time and by any member of the team, including the patient and family caregivers. Feedback will be most useful if it is:
- °Õ¾±³¾±ð±ô²â—If you wait too long, facts are forgotten, and the feedback loses its "punch." Feedback is most effective when the behavior being discussed is still fresh in the mind of the receiver. Feedback delivered several weeks after poor or excellent behaviors have occurred is too late for maximum effect. That said, while timeliness is valuable, if the recipient of the feedback is visibly upset, stressed, or juggling multiple tasks, delay your feedback until the person can better process it.
- ¸é±ð²õ±è±ð³¦³Ù´Ú³Ü±ô—Feedback should not be personal, and it should not be about personality. It should be about behavior. Never assume you know WHY the person's performance was flawed. Instead, describe the performance concern and allow them to explain why they did what they did. When you attribute a team member’s poor performance to internal factors (e.g., you were careless, lazy, unmotivated), you can damage their sense of self-efficacy and impede their subsequent performance.
- ³§±è±ð³¦¾±´Ú¾±³¦â€”The feedback should relate to a specific situation or task. Imagine that you receive feedback from a peer who tells you that your surgical techniques need work. That statement is too general to use as a basis for improvement. The person receiving feedback will be better able to correct or modify performance if specific actions are mentioned during feedback.
- ¶Ù¾±°ù±ð³¦³Ù±ð»å—Goals should be set for improvement.
- °ä´Ç²Ô²õ¾±»å±ð°ù²¹³Ù±ð—Be considerate of team members' feelings when delivering feedback and remember to praise good performance. A feedback message will seem less critical if you provide information on the positive aspects of a person's performance as well as how the person might improve. Generally, fairness and respect will cushion the effect of any negative feedback.
- Given in an appropriate setting—Negative feedback should never be expressed to individuals in front of other team members. Doing so could embarrass the recipient.
- Given at an appropriate time—You must consider when and where to give feedback to an individual. Negative feedback delivered at the start of a shift may distract the person while they care for patients. On the other hand, feedback right before a long weekend may delay the followup conversation and spoil extended time off.
Because effective formative feedback is key to effective teamwork, you may want to watch available videos illustrating the concept. These include:
- Formative feedback in a long-term care setting.
- Assess whether the feedback observed in the video was consistent with the principles of good feedback noted above. Was it timely, respectful, specific, directed, and considerate?
TeamSTEPPS: Feedback (Long-Term Care) (11 seconds)
Because effective formative feedback is key to effective teamwork, you may want to watch available videos illustrating the concept. These include:
- Formative feedback in a long-term care setting.
- Assess whether the feedback observed in the video was consistent with the principles of good feedback noted above. Was it timely, respectful, specific, directed, and considerate?
TeamSTEPPS: Feedback in Inpatient Medical Teams (29 seconds)
- Formative feedback shared with a medical technologist.
- Assess whether the feedback observed in the video was consistent with the principles of good feedback noted above. Was it timely, respectful, specific, directed, and considerate?
We also encourage you to reflect on your own sharing and responding to formative feedback using the following questions.
First, identify the last time you provided substantive feedback to another team member.
- Which of the characteristics of effective feedback did your feedback include?
- What one area do you most need to work on to improve for the next time you provide feedback?
When is the last time you received formative feedback from another team member?
- What is one thing you can change to improve how you respond to negative formative feedback from others?
- Is it possible to receive negative formative feedback from other team members while preserving a positive working relationship? If not, what can you change?
