Gift of feedback


Feedback is a gift, which can dramatically change a persons life but can also have adverse effects if not given carefully. Feedback can give insights to difference perspectives and views of others. This can encourage reflection on day to day practice. Which then leads to changes in behaviour and how things are done in the future. Well placed feedback can motivate and improve.


There are many ways to give feedback. Casual, informal or formal.  Face to face or written or implied. In our day to day relationships each person is picking up feedback based on tone or voice and body language. Well placed feedback encourages and developes a person


Feedback can constructive or destructive. The line between the two can be fine. In some circumstances feedback can be firm, explicit and clear, but it still needs to be constructive and lead to positive change that benefits the individual. Destructive feedback can lead to withdrawl and cause psychological scarring where the feedback is relived with associated negative feelings.


Giving Feedback with thought involves preparation. Protected time and a location where interruption is unlikely. A “feedback sandwich” of positive encouragement followed by constructive well worded suggestions and then summary encouragement is one objective

GIFT is from “Medical education, professional learning and action research in the health service: assessment, interventions and future models for general practice vocational training of senior house officers” Dr Mark Rickenbach  PhD thesis 2003 p317

Feedback sandwich also known as criticism sandwich is from Iles,V. 2005. Really managing healthcare, New York: Open University Press

Approaches to behaviour change – giving feedback on an issue

How do you give some feedback which may be difficult to accept and take on board positively

Feedback sandwich (or criticism or shit sandwich)
Encourage first, feedback then encourage
Mention issue then allow time to reply and consider
Mention issue briefly then move on – drip feed or nudge
Share the same issues – I have the same problem
Share the problem – how can we both work on this?
This is an issue – how can we handle it?
Look at all the options together
Introduce a new model to try out with the issue as an example eg DESC Decide Explore, Consequences
Look at future outcomes as a result of the issue
Get concrete feedback
Suggest Multi source feedback to check if an issue
Suggest consider issue as if they were a GP partner or trainer or another person
Open up feelings “you seem really defensive”, “how do you feel about this?”
Just tell them the issue
Challenge then say forgive me for saying.
Share the career or work goal overall then see how the issue fits
Compromise eg offer a later start
Offer a sweetner eg a course
Pick the battle – does this issue matter, is it worth mentioning, is there a bigger goal?