All right. So today, thank you again for coming in. We will be talking about Fierce Feedback, the Art of Receiving Feedback in Difficult Situations. We'll be presenting this. My name is Michelle Imperio, and we'll be talking first about the foundations of feedback, building your toolkit. Take a quick look at this, and if you can't get this QR code, that means you're not sitting close enough, so please move up. I'll leave this up for a second. We'll give you time to scan the QR code. This will give you access to the handout for today's session. I'll leave it up for a couple more seconds. Okay. So again, my name is Michelle Imperio. I'm currently a second year pulmonary and critical care fellow at the Loma Linda University in Southern California. I have nothing to disclose and neither do my colleagues here who will introduce themselves as well right now. I will introduce them for you. So we have Abdullah Alismail here on the left, who is also from Loma Linda, California, who works in education. He's a PhD as well and has a background in respiratory therapy. Then we have Elizabeth Batchelor, who's currently based out of Virginia, working as a staff in pulmonary and critical care. None of us have any disclosures. So today's learning objectives will be going over throughout the session. So just take a quick look at this slide as we'll go through them quickly. So first of all, what is feedback? Of course, we all know what feedback is. It's been described as early as the seminal article by Andy back in 1983 in JAMA, information that describes students or house officers' performance and seeks to compare their performance and their knowledge with a given standard so that we can try to get them to improve their performance and knowledge. We want to emphasize that it's a dynamic process and it involves both the senders, who is typically the person giving the feedback, who is a teacher, as well as the receiver, who is the student usually, who is receiving the feedback. The goal, of course, is to improve the knowledge and improve the performance toward a common goal by encouraging them to repeat behaviors that are positive and to stop doing or to change doing behaviors that are negative. So feedback is a gift, but sometimes the person receiving the feedback receives it something like this. So it's not always a wanted gift. What this reminds us is that the role of the feedback receiver is actually pretty important. They have to decipher the information that they're given, and they have to decide or decide not to accept it and then implement the changes in behavior. What this means is that ultimately, the person receiving the feedback holds the true power to interpret that information, and then to make that decision to or not to incorporate that input and make the behavioral change. So today, we're going to be talking about receiving feedback effectively. I know we've gone on and on, and you've probably heard lots of things about how to give feedback effectively. But what about receiving it? Because that's just as important, if not more important than giving feedback. So let's talk a little bit about background and theory. You all know about self-determination theory, which reminds us that people are motivated in different areas of the spectrum. Some people have or seem to have no motivation at all. They seem to have a motivation, and some people have extrinsic motivation where they're motivated to do things by external things such as deadlines or grades. What we really want is for people to be intrinsically motivated. What self-determination theory tells us is that people's intrinsic motivation is fueled by how much they are able to meet the psychological needs of competence, autonomy, and relatedness. What's important to remember is that constructive feedback, which we all think of as the most important type of feedback, has a tendency to potentially undermine all three of these things by saying, well, you're potentially not as competent as you thought you were. You're also not as autonomous as you would probably like to be because you're needing someone like me to give you this feedback and help you see it better. It may or may not change or potentially alter or even damage the relationship between the person who's giving and receiving the feedback. So that's something to keep in mind. We'd also like to remind you about the theory of goal orientation, which is very related to the concepts of intrinsic and extrinsic motivation. So people who are more performance goal-oriented want to just get that A, get that high marks or honors in that class, or get the high evaluations. But what we really want is for our learners to have a learning goal-oriented mindset, where they just want to learn for the sake of learning, for the sake of knowledge and improvement and competence. So let's go on to the practical tips and how to receive feedback effectively. We'll go through these quickly, and I'd really like you guys to refer again to that handout that you got on the QR code, which is on that first slide, which goes through these as well. So remember that to be able to receive feedback effectively, you need to know what good feedback is. Just keep that in mind as we go through the rest of these tips. So before you even get the feedback, be proactive and create and communicate the shared goals between you and the person or the people who will be giving you feedback, so that you can be on the same wavelength when you're talking about the feedback later. Then take initiative and ask for feedback frequently. At the same time, just remember that unlabeled feedback does happen frequently, and be prepared for it, and remember that it may come at unexpected times. It's important to build rapport and relationship with evaluators, because that will help as well when these unprompted or unlabeled feedback sessions do occur. Then when the feedback is happening, ask for clarification. Don't assume that you know or you understand what the person giving you feedback is saying. It's okay to ask for specifics. You should ask for specifics. We all know as someone who's giving feedback, that you should be as specific as possible. When someone tells you or if someone tells you something that's very generalized, something like, oh, your technique in this procedure, for example, is bad. What you really want to be hearing is something specific and actionable, something like, well, when you hold your hand this way, you're more likely to X, Y, and Z. However, don't interrupt and don't be defensive. Instead, take responsibility for actions, because sometimes that critical feedback is necessary. Avoid the three Ds, and you'll get to see these a little bit more on the handout as well. But denial, discounting, and distancing. Denial, well, maybe it wasn't really a mistake. It's just a style difference, or potentially maybe they're discounting it. Well, it wasn't really my fault. It was the whole situation, or maybe even distancing. Okay, so maybe it was a mistake, but everyone makes mistakes. Do we really have to call this out and even have this session right now? Instead, play an active role in creating your action plan because you're given feedback for a reason. However, recognize your limits as a person receiving feedback. Sometimes the feedback is just not given well at all. The setting may be wrong. The timing may be wrong. Other factors may just not have been ideal. And maybe, for example, there was just an overwhelming amount of critical or constructive feedback that was given. It's okay to ask for just one thing to improve. Or if you don't think that you have good enough rapport with the evaluator to ask for that, it's okay to just mentally, internally focus on one thing at a time to improve, remembering that it's normal to need time to process and to reflect, especially on large amounts of constructive feedback. Not all feedback must be accepted. That being said, remember that feedback is ultimately a gift and always thank your evaluator at the end of every feedback session.

feedback

intrinsic motivation

self-determination theory

goal orientation

performance improvement