Feedback- Keeping it Manageable!

We've all done it - we have a game plan in mind as to how to share constructive feedback to our student in “small and digestible bits”. But then the words start pouring out...

Shari Harley's post really speaks to this:  “When giving feedback, less is more” . It is a quick read and there are some natural links to providing feedback in a clinical situation:

• Shari compares planning a feedback conversation to packing for a trip; it is important not to “over pack” a conversation with too much information. This can cloud your message and depending on the student, it might feel uncomfortable or hard to process. 

• The feedback conversation can go in many directions. Taking a few minutes to think about the specific behavior you are targeting can help to focus the conversation. Try leading with that.

• If you find yourself becoming “long-winded,” take a moment to pause and check in with your student to gather their perspective. This is a key step in understanding how they are receiving your feedback and ultimately how they are going to act on it.  For example:

• “What do you think?”

• “How do you feel about what I said?”

• “Do you agree with what I said?”

For more tips on feedback, check out other posts under the “feedback” category of this blog. Providing constructive feedback is such a necessary part of the learning experience but it is truly a skill to learn to do onto itself!

Teresa

Revised by Julie, 2024

Does that really meet my expectations?

This tip was inspired after chatting with an educator shortly after midterm.  What I believe I heard from her was that she had a little of voice inside her asking, "did that really meet my expectations?"

I've heard this story many times before.  We want to give the benefit of the doubt. We're not sure if what we did (or maybe, did not) observe was that big of a deal.  But something just doesn't feel right giving a "meeting expectations" when your gut feeling is that your student isn't.

Do either of these examples resonate with you (which I have often heard over the years):

You have outlined some things for the student to complete (e.g. chart reviews), however the student doesn’t seem to be taking the initiative.  It isn’t until you remind them that there is follow through, which may even be after the deadline you originally gave.  

You have a student who is very shy.  While polite and responsive to questions, they rarely initiate conversation with you and you have not observed them talking with other team members - even communication with clients is minimal unless prompted by you.

While in many cases, students make improvements and meet your expectations by final without specifically targeting the area, some students need a stronger cue. It is better to err on the side of being explicit and upfront than to assume your student understands they are not meeting expectations in some way (since they very well might not know until you say so!).

So what do you do?

Midterm has past or is still a ways away ... 

Give clear and specific feedback as soon as possible. The sooner they understand what particular skill(s) are not meeting expectations (and how!), the sooner they can start the work.

As placement continues, make this a priority area to provide consistent feedback about so there is no “guessing” involved on how they are progressing.  That said, ensure that you continue to focus on their strengths too!

To support your student's understanding of what it means to meet expectations, consider sharing these points:

·       Share your observation with the student. “I’m noticing that….”

·       Support their ability to understand how this concern has implications for practice now and in the future. “This behaviour might be misinterpreted as…..” or “The impact this might have on creating connections with our clients is…..”

·       Explain what your expectations are (i.e. what would meeting expectations look like) and link it directly back to the evaluation. “By midterm I expect that you will be able to….." or "For this placement level, my expectations are that you can do this skill independently..."

Midterm has arrived ...

Continue to provide clear and specific feedback as described above.

Use the Competency Rating Scale to quantify your students performance to help support their understanding about the significance of the concern(s). The scale is a great way to show how far 'off' your student is from meeting expectations and open discussion on what would need to be done to reach expectations by final. If you choose to evaluate them as not "meeting expectations," it is essential that you contact the Fieldwork Team so we are kept updated and can add support sooner rather than later.

If you choose to still evaluate them as "meeting expectations," be very clear that your expectations will be rising for final.  Simply performing as they have been will no longer be enough—they must actively work towards making improvements. 

Ask the student to create an action plan for meeting the expectation.  Students get experience with developing professional development plans in the program (and this is practice for real life also!). Yes, it is fine to expect this be done outside of fieldwork hours. You might have some suggestions here on some strategies they can use. 

The thought that your student may not be meeting expectations will never be an enjoyable one to entertain. Please do not grapple with these feelings too long. Connect with the Fieldwork Team so we can confirm what it means to be "meeting expectations" at each placement level and how we, altogether, can support your student to move forward.

·      

 Lisa

Updated by Julie, 2024 

“Put those away” and other awkward feedback

While tips on providing feedback isn’t a new topic for this blog— I do know I haven’t had the guts to be this direct before.  Today’s tip tackles awkward feedback—addressing issues like cleavage, body odours/scents, tight/low-rise pants, falling asleep, texting during work hours and so on.

I feel (and have heard from educators) that these are the hardest issues to provide feedback on.  I also feel that even though we've had opportunities to give this sort of feedback our natural reaction is to just hope the issue will just get better on its own.

I could blather on here, but this link called Giving Feedback - 3 Funny Examples of Giving Employee Feedback says it well.  Shari Harley provides an entertaining and practical way to execute giving awkward feedback.

The clip is almost 15 minutes long.  While I recommend you watch the whole thing, here are the highlights (the time in red is what minute the topic is addressed if you want to skip to that part).

4:30    She demonstrates how to tell someone to “put the girls away”.  Her steps are to:

1. Introduce the conversation “I’d like to talk to you”
2. "I’ve noticed that…"
3. Provide a statement regarding the impact of this 
4. Provide examples (I think this is number 4 in the video; she skips what #4 is)
5. Ask for her take on it (The most likely human response is defensiveness so don`t be surprised by this)
6. Make a suggestion (The Winnipeg version of her example is the store Garage)
7. Ask “are you willing to do that”?
8. Finish up with something like “Thank you for your time; I’m glad we had this discussion.  I know it was awkward.”  Then end the conversation (no one wants to hear about something they are doing wrong for more than 2 minutes).

8:30 to 9:45  She demonstrates the process again with giving feedback about body odour.

11:55  She demonstrates the process again to address texting in front of clients.

Some other gems in this video include:

• When you tell someone the truth you are doing them a favour.
• Don’t expect that just one chat will change the behaviour.  Be prepared to address it again.  She suggests that you say something like “Be prepared to talk about this again.  If I see it getting better I will let you know and if it`s not getting better I'll let you know." 

If you have any other resources, tips, or strategies about giving awkward feedback, please share with us!  

Lisa

Revised by Julie, 2024

Stuff from the top of my head: Tips from an OT with 24 years of experience

Sharing tips amongst each of you is an important part of this blog. There is so much we can learn from one another, which is all part of being a community!

We asked you to share your tips. I offered some sentences for you to "fill in the blanks" to help to get the thinking going. One of our educators took us up on the challenge. This was what came off the top of her head…

Something I do to prepare is… 

Review the student manual and update materials.  This makes me think about seeing my job for the first time. Would this make sense to a first glance?

One thing I’m going to try for this placement is… 

To integrate theory in a more conscious manner, working through it with the student…co-learning!

Something I remember that my educator did when I was a student was… 

Ask me how I felt I did before providing me with any feedback. Self-reflection proved to be a great tool for life.

I would tell a new educator ... 

That you don’t need to know everything.

Something that makes me nervous is…

Not knowing everything! Despite my earlier note…however, it’s okay not to know everything and modeling how to get through an area of limited knowledge / experience is a great teaching moment, both for myself and a student.

I'll add here, with this educator's 24 years added to the 3 OTs in the post “you don’t need to know everything,” we have at least 95 years of experience behind this tip.  If you are pretending that you have all the answers, give yourself permission to stop!

There is still so much more to learn from each other. For now, thank you to this educator for sharing these insights!

Lisa

Revised by Julie, 2024

 

 

“What I’d tell a first time educator” Advice from OTs with experience

Being part of a community includes supporting the learning and growth of each other - not just of students entering the profession but also of those who are already in the field.

Here are a few suggestions shared by OTs with experience when asked, 

"What would I tell a first-time educator?"

I like to sit down with students on their first day and talk about

• the goals they have,
• what they hope to learn,
• what they are interested in,
• and most importantly, what they know about how they best learn and communicate

I have found I have had to change my approach with [each] student, some are “immediately following de-briefers”, some are “take some time to think then debriefers”, some are “list people”, some are “single task oriented”.  If I get that from them [near the start of placement] then we can work more effectively and efficiently together.

One thing I try to do is seek out feedback from my student:

• what does he/she feel comfortable taking on?
• what does he/she want more opportunities to observe?
• does he/she feel like she is getting enough feedback? The right kind of feedback?

I also make a point of using the eval package to plan out our goals for the following week of placement (e.g., observing a specific type of assessment, doing an initial interview, planning and running a group therapy session, writing a discharge summary, etc.). This keeps us on track and is an opportunity for my student to highlight things he/she is particularly interested in or wanting to work on.

I would say that my process has always been to give them a good introduction to the environment and to the key people that they would need to rely on for information.  Then, to observe me in various interactions, practice them with each other (if in a collaborative placement), be observed interacting with clients, then doing it independently and talking  about it later.

I really like to try and be collaborative with students and clearly outline expectations or reasonable progressions for the goals they are trying to achieve.

I tell all my students that I feel the first (and perhaps the most important) step, with any patient, is to establish a rapport with the patient.  Nothing can move forward without such rapport.

Be open to feedback, you likely will learn more from your student then you think and take the experience as the gift it is.  

Lisa

Updated by Julie, 2024

Giving Positive & Constructive Feedback- "POP" Style

There are a variety of different styles that help to organize providing feedback. One such style that the students are familiar with is “POP”.

For those of you who are not familiar with the term “POP” ……

P- A positive comment is followed by….

O- An “opportunity for change”/ “area for improvement” followed by ….

P- An additional positive comment.

In fieldwork placements it might look like this:

Scenario:   Treatment session for client on stroke unit. “I am going to give you some feedback about your transfers today with “Mrs. J.”

P- You did a nice job of cueing her to attend to the left side of her environment.

O- An area for improvement is to work on your guarding technique.  I would like to see you position yourself closer to Mrs. J. in order to be able to assist her if she loses her balance.

P- Your verbal instructions for the transfer were very clear and concise.

In our experience, many students appreciate this balanced feedback style - sometimes calling it an “op” or a “po” if only one positive comment is provided. It has often served as a comfortable “discussion opener” about feedback, and a framework for highlighting strengths as well as areas for improvement; especially when a student is struggling. 

Many of you may be delivering feedback in this style, but just not using “the fancy acronym.” Some people may recognize it as the “sandwich” technique for delivering feedback. 

If this is new to you, we hope that you might find an occasion where this style of feedback is helpful.  

Teresa & Lisa

Revised by Julie, 2024

Quick Tips for Providing Feedback!

Receiving and integrating feedback is an integral part of learning during fieldwork. Here are a few quick tips on how to provide feedback to your student:

Schedule time for feedback. The sooner after a session is typically better but do the best you can in your busy practice environments.

When you can’t give feedback right away:  jot down some quick notes/cues for yourself when you see/hear something you’d like to provide feedback on.  This can help you a) remember when you have time to give the feedback b) remember when you have to sit down to fill out the evaluation and c) keep a record of the student’s progress.

You can’t (and shouldn’t) give feedback on everything.  Consider:

o    What areas would the student most like feedback on?  These might relate to their personal learning needs or areas that have previously been identified as areas of growth.  Popular picks are often interviewing skills and report writing.

o   What are the areas that you will be specifically evaluating?  This will allow the student to integrate the feedback during the placement before the final evaluation.

Check in with the student first.  "So how did you think that went?  Did it go as expected?”  The ability to evaluate our own performance in an important life-long skill for a clinician.

Check in with the student again to problem solve how to address future performance.  “So how will you handle that next time?”  “What can you do to improve in this area?”.  Again, these are the important questions that we as clinicians need to ask ourselves.

Be explicit when you are providing feedback.  Call your quick meeting times “feedback sessions”.  Start sentences with “I’d like to give you some feedback on….”  For more info on this tip, check out the tip: “Use the F word more often”.

Try to keep your feedback as specific as possible.  Focus on the decisions and the actions of the student.

Keep the feedback balanced.  Everyone wants to hear the positive as well as opportunities for improvement! It's also important to know what to keep doing!

Deliver feedback in small, digestible quantities when possible.

Lisa

Revised by Julie, 2024

Use the F word as often as you can

Just in case you did not figure it out - the 'F' word stands for FEEDBACK.

True story:

OT Fieldwork educator thinks: Wow, am I ever giving a lot of Feedback.

OT student thinks: Hmm, I wish I could get more Feedback.

As a fieldwork educator, you may be providing the student with a lot of feedback throughout the day.  Sometimes, we have found students only “hear” your comments as feedback when they occur in a formal feedback session. You are very likely providing the student with many tips, suggestions, and opportunities for improvement throughout the day.  Sometimes, you don’t have to necessarily provide more feedback … just highlight the feedback moments throughout the day that you are already providing.

Rather than saying: “The next time you open your interview, you may want to try….”

Try: “I’m going to give you some feedback for the next time you open your interview…”

If saying the F word all day long is too offensive for you, negotiate another feedback cue.  Something that says, “ok here’s some feedback” like waving a feedback flag, tugging your ear, or doing a cartwheel.  Really, it’s up to you.

Lisa

Updated by Julie, 2024