5 Steps to Effective Feedback

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Veterinary medicine is a challenging profession, as many of us are medical professionals as well as small business owners or employees.

As such, in many instances you are long-term members of a team who share close personal and professional relationships. But this also can be a difficult setting in which to provide honest and regular feedback.

The majority of veterinary medical education is devoted to how to diagnose, treat, and care for animals; only a small part of the educational process focuses on how to successfully run a small business. When topics such as employee job descriptions, performance feedback, and employee motivation are included in veterinary medical education, students find it difficult to focus on these issues while having to learn a daunting amount of medical information. Without training and experience, veterinarians may view employee feedback as being confrontational and may, therefore, be uncomfortable with the process. Given the lack of formal training on employee feedback, the misunderstanding of its importance in business management, and that people innately tend to avoid conflict, it is not surprising that an established program of regular team member feedback is rare within veterinary medicine.

A successful way to motivate team members is to provide them with feedback on their professional goals and the goals of the practice. Creating an environment in which feedback can be heard, accepted, and acted on first requires a climate in which effective feedback is expected and desired. Moreover, if such a climate is to persist, all team members must continually practice these skills.

Five key steps for establishing a culture of effective employee feedback:

1. Define the difference between feedback and evaluation for your practice team.

The first step in developing an effective feedback program in your practice is to define the program and its purpose, namely the difference between evaluation and feedback. The goal of an evaluation is to grade or rate an individual’s global or overall performance by critiquing the person’s past performance. It is typically a scheduled event that occurs in a formal setting. In an educational setting, an evaluation may be an examination or test. In a practice setting, an evaluation may be associated with an annual contract renewal.

In contrast, feedback is aimed at maintaining positive aspects of an individual’s performance or changing something about current performance in order to improve future performance. Feedback enables individuals to become aware of their behavior and skills and their impact on those around them. Feedback, as opposed to evaluation, is given in a timely fashion relative to the performance, is frequently provided in an informal setting, and is related to a specific action rather than the individual’s global performance. Feedback may be provided on a regular basis with the goal of continued performance improvement through suggestions, goal setting, and follow-up conversations.

Establishing the concept that feedback is provided to all members of the team to better the entire team helps to eliminate the negative feelings associated with evaluation programs.

2. Jointly develop goals for individuals within the practice team.

The most successful and valued feedback is provided to an individual in reference to his or her own specific goals or objectives. Therefore, it is best that goals and objectives be developed and defined jointly by the employee and the employer. Without joint development of goals and objectives, expectations may be misaligned and conflict may ensue. The existence of accurate job descriptions and a statement of the values of the practice may aid this goal setting. The development of SMART goals (see below) using the Career Road Map handout enables all individuals to have a shared vision of the process of goal setting.

SMART Goals are:
• Specific
• Measurable
• Attainable
• Realistic
• Timely

A Specific goal for Sue, our front desk staff team member, might be to become more welcoming to clients as they enter the practice by greeting them and asking a broad open-ended question to engage them in conversation.

3. Begin feedback conversations with the request for self-assessment.

After witnessing firsthand the performance of a task, duty, or interaction, feedback should be provided promptly. Begin the conversation by checking the individual’s readiness to hear the feedback. This is done as the meeting begins, by first reminding the individual of their stated goals and then requesting that the team member provide a self-assessment of his or her performance.

Sue, you’ve been working on engaging clients when they enter the practice. How do you feel that’s going?

What are some specific examples of things you’ve said that you feel have worked to engage the client?

This focuses the feedback session on performance relative to goals and affords the team member the opportunity for reflection. In addition, this provides a snapshot of the employee’s awareness of his or her own actions. Keep in mind that it is rare for individuals to begin a self-assessment with positive attributes of their own actions. Therefore, it is important to direct the beginning of the self-assessment toward things done well instead of allowing the team member to focus on things that require improvement. This sets the tone for a feedback session balanced between behaviors that should be reinforced positively and continued (or even expanded) and things that would benefit from change. Ask for specific examples of things that the team member has done well and specific things that he or she could improve. During this interaction, it is important to convey a verbal and nonverbal message of listening and understanding.

4. Provide balanced and specific feedback that is focused on the defined objectives and goals.

Following the self-assessment, it is important to focus feedback on areas related to the individual’s goals not adequately covered in the self-assessment. A long list of “things to change” may become overwhelming to a team member, resulting in little effort devoted to changing behaviors. It is also important to provide specific examples. Consider the following scenario.

You are sometimes rude to our clients.

In this instance, the feedback is harsh, personal, and nonspecific. What should this individual do to change his or her performance? What is he or she doing that is perceived as rude?

You are doing fine, good job!

While this feels like positive feedback, it does not provide any specific identification of what is being done well. How would this team member know what to continue doing?

Specific examples provide more constructive feedback:

I noticed that when you spoke with Mrs. Jones your tone of voice changed as you confirmed she hadn’t given the heartworm preventive. In response to the questions and the change in your tone of voice, she dropped her eyes and gave 1-word answers to your questions.

In this example, the evaluative term “rude” has been removed and replaced with a description of a series of events. In this way our team member can reflect on those observations and events with less of a feeling of being judged. This is an example of descriptive feedback. Descriptive feedback reports what happened. Evaluative feedback places a value judgment on the performance. Evaluative feedback frequently invokes a feeling of defensiveness on the part of the individual receiving the feedback. Descriptive feedback is more effective at producing the change we desire because the individual receiving the feedback is more willing to listen.

Another key step when providing feedback is to suggest alternatives. This gives the individual specific ways to alter the performance to become more successful.

Sue, some ideas of things that you might say as clients enter the practice are:
Hello Mrs. Smith, what brings you and Bruiser in today?
Hello Mrs. Smith, it’s good to see you. How is your day going?

In both of these examples, you engage Mrs. Smith by using her name and show interest in her, her pet, or her situation.

5. Plan future feedback sessions with employees and explain what steps will be taken prior to the meeting.

Like athletes, when veterinary healthcare team members receive feedback or are coached, they must then have the opportunity to repeat the task or performance with this feedback in mind. This opportunity for performance followed by additional feedback fosters constant improvement and inspires sustained effort and personal growth. To cement this opportunity for growth, there must be opportunities for follow-up discussions and revisiting the goals after the individual has had the opportunity to employ the feedback originally offered. Being a member of a veterinary team in which feedback becomes commonplace and is welcomed establishes the foundation for practice success and team member satisfaction. | EVT 

5 Steps to Effective Feedback
•  Explain to employees how feedback differs from evaluation
•  Help employees develop individual goals
•  Ask employees to self-assess before providing feedback
•  Give balanced and specific feedback related to employees’ goals
•  Plan future feedback sessions with employees

 5 Steps to Effective Feedback
Karen Cornell, DVM, PhD, DACVS

Reference
1. The Practice of Management. Drucker PF—New York: Harper Collins, 1954.