While I have worked in pediatric surgery for nearly 30 years, I just celebrated my 12th anniversary working for pediatric surgery and trauma at Children’s Hospital of Pittsburgh of UPMC. I still work for the same “surgical boss,” Barb Gaines. (Barb has three children, and I often tell her that I am partial to the middle one because she was pregnant with him when she hired me). Several years ago, Barb said to me: “When you interview people, you have to tell them how hard it is to work with surgeons.” My response was, “OK, but I don’t think it is hard to work with surgeons.” Barb meant that folks in our division have to be self-motivated, because there is often minimal direction and feedback. From my perspective, that works great. I don’t want someone to give me a job or project wrapped up in a pretty package with a nice bow and check up on me frequently to see how I’m doing. I prefer to be told what must be accomplished and given the freedom to reach that goal, seeking out my own resources for assistance as needed.
Having said all of that, feedback is important. We recently had a pediatrician, Stephanie Dewar, MD, give a conference to our entire team (faculty, fellows, residents, medical students, nurse practitioners, and nurses). There were lots of things that she could have talked to us about that we’re fairly ignorant of, but she was invited especially to give a talk on “Giving Effective Feedback.” Our clinical director (Dr. Gaines again) wanted this talk shared with the entire team, not just the faculty, because she feels strongly that ALL of us need to know how to give effective feedback. My bias is that we all need to know how to receive effective feedback, as well.
Anyway, Dr. Dewar gave a fantastic talk that was incredibly well received. She began by sharing the following quote from Adam Urbanski, president of the Rochester, New York Teachers Association:
“Anybody who believes that all you have to do to be a good teacher is to love to teach also has to believe that all you have to do to become a good surgeon is to love to cut.” (Mansnerus, 1993, p.1)
First, what is the difference between feedback and evaluation? According to the Merriam Webster Dictionary (www.merriamwebster.com), feedback is “helpful information or criticism that is given to someone to say what can be done to improve a performance, product, etc.” Feedback is ongoing, descriptive, and nonjudgmental. Feedback is different from an evaluation, which is a final judgment of someone’s performance. We then discussed barriers to effective feedback. Responses included lack of time, lack of privacy, concern that the behavior is an aberration (not a pattern), previous experience giving feedback to the individual that was unsuccessful, false confidence that the person will learn from the mistake on his or her own, and my favorite (from my boss, yes, a surgeon!) “We don’t want to make them feel bad.” By the end, Dr. Dewar even had our division chief and junior fellow acting out a role-playing scenario practicing some of the strategies we discussed.
An article in Pediatrics by Gigante, Dell, and Sharkey (2011) provides an excellent foundation for understanding the five recommended steps of effective feedback:
- Ensure the learner/performer knows the expectations from the beginning.
- Ensure that the learner/performer receives the feedback by highlighting that it is going to be given: “I am going to give you some feedback.” Privacy is best!
- Encourage the learner/performer to self-evaluate. “How do you think you are doing?”
- Provide feedback on specific, observed actions and modifiable behaviors.
- Develop a plan for improvement.
Certainly, we, the members of the American Pediatric Surgical Nurses Association (APSNA), in our various roles, have the opportunity (and need!) to give feedback regularly. APSNA needs your feedback (input) as well. As you’re reading this, I am more than halfway through my term as President, and my fellow board members are either one quarter or three quarters through their terms. How are we doing? Do you like the professional publication of our Journal of Pediatric Surgical Nursing? Have you and your colleagues utilized the PNPSourCESM for online continuing educational modules from our conference? Where do you think we as an organization should focus our time, talent, and resources? Did you know that every 3 years APSNA updates its strategic plan based on many data sources, including feedback from you, our members? We are in the middle of our strategic planning process now.
Your feedback counts. After our conference in May, the evaluations were carefully reviewed, and Kathy Leack and her Program Committee used the information gleaned to begin planning to make our 2015 conference better than ever! You spoke; we listened. You should find more clinical talks and more free time. Registration will soon be open for this, our 24th Annual Scientific Conference April 27–30 in Ft. Lauderdale, Florida. Hope you are able to join us and then give us valuable feedback on the conference (and the beach!). Thank you for your ongoing commitment to the improvement of all that APSNA is and does. Please contact me directly with YOUR feedback at firstname.lastname@example.org or email@example.com.
The author thanks Stephanie Dewar, MD, Pediatric Residency Co-Director, at Children’s Hospital of Pittsburgh of UPMC for the inspiration and some of the content for this article.