When asked—and believe me, I've asked—most dental employees say they either don’t get enough feedback or only get negative feedback. There’s actually a term for this type of supervision: seagull management. It refers to bosses who circle their employees, swoop in periodically to poop on them with criticism, then fly off again, leaving behind a mountain of you-know-what on everyone’s shoulders.
Although most dentists don’t aspire to be seagull managers, they may be perceived as such because dentists typically are not generous or skilled with the feedback they offer their employees.
So, let's take a peek into the do’s and don'ts of effective feedback.
What is feedback?
Feedback is often prefaced with words like positive, negative, critical or constructive. But these terms are problematic, because they are subjective judgments suggesting that feedback might be good or bad or occasionally helpful. Every employee knows that if a dentist begins a sentence with "I'd like to give you some constructive feedback,” they should brace themselves for bad news.
Instead of these loaded words, let’s define feedback simply as an exchange of information. Feedback can either be reinforcing or change-oriented. Reinforcing feedback means that a behavior should be continued because it’s getting good results. Change-oriented feedback means that the employee should change a behavior because it’s not leading to good results.
That insight leads to a great question: What is a good result? A good result isn’t pleasing you, the dentist. Feedback is about achieving an objective outcome. Reread that last statement, because it has crucial implications.
Feedback isn’t praise
Effective reinforcing feedback is not “Good job!” or “I really appreciate that.” or even “Thank you!” Are these nice things to say? Sure. But these are examples of praise, and praise is equivalent to eating twinkies; fun in small quantities as a treat, but not nutritious food to grow on.
There are three problems with praise:
- It doesn’t define the behavior you want repeated.
- It can make employees uncomfortable.
- It can be condescending because it mimics adult to child communication instead of adult to adult.
Let’s use a sports metaphor to illustrate why praise and pleasing you isn’t the goal. Basketball players know that their ultimate objective is to get the ball in their team’s basket so they can score points and win. The coach’s happiness is a byproduct of winning; but it’s not the purpose of playing. Imagine a game where athletes continually check their coach’s facial expressions instead of the score board to see if they’re doing the right thing. It would be absurd, wouldn’t it?
Your job, like a coach’s job, is to create independent, self-evaluating professionals who adapt their behavior in order to achieve an objective measure of success.
How to provide effective feedback
Reinforcing or change-oriented feedback is laser-focused on how the employee’s behavior impacted a situation. Feedback can’t focus on attitudes, because attitudes can’t be observed or measured. For example, telling an employee they seem unmotivated is not good feedback, because you can only infer that motivation is the problem. Feedback must focus on observable behavior in the context of achieving an objective goal. It contains these components:
- A neutral description of the situation/incident you observed
- The impact the employee’s behavior had on the patient/practice/team/you
- The desired next action (keep doing or change)
Here’s an example of reinforcing feedback:
I overheard you ask an open-ended question of Mr. Dale. It revealed a concern we hadn’t known about before. Because you asked him this, he decided to get an implant for that tooth. This is exactly the kind of communication that helps patients accept treatment.
If we dissect the message, you’ll see how it follows the feedback formula:
- It contained a neutral description of the situation: You heard an open-ended question.
- It described the impact of that question: The patient agreed to treatment.
- It reinforces the behavior: Repeat this behavior because it leads to case acceptance.
Here’s an example of change-oriented feedback:
When Mr. Dale was in the chair, I observed that you interrupted him a few times while he was describing his health history. I saw him stop talking, look downward, and cross his arms. If patients are discouraged from sharing their concerns, they become less likely to accept treatment. In the future, I’d like you to observe patients’ body language more closely and change your communication to match what the patient needs. This will allow patients to feel they can trust you, and by extension, our care.
This message also followed the formula. It described a specific incident using neutral terms. It described the impact of the miscommunication. And it told the employee how to modify their behavior in the future. Note that the desired action is described as something the employee should do: “In the future, observe the patient’s body language” instead of in negative terms “Stop interrupting.” Telling your employees to stop doing something is only partial feedback. Effective feedback should directly describe what you want the employee to do differently so that it’s clear to both parties.
Time and frequency
Aside from how, the next feedback obstacle most dentists identify is when. Ideally, feedback conversations are private, and especially for change-oriented feedback, allow sufficient time for a dialogue. This is one reason to reserve 30 minutes each day for admin time. If this isn’t possible, make an appointment with your employee. Phrase it like an invitation instead of a punishment. “Hey Employee, I’d love to find some time today to have a coaching conversation. I think we’ll both find it helpful. When would be the best time for us to chat?”
To avoid being perceived as a seagull manager, give reinforcing feedback three times as often as change-oriented feedback. Ask the employee for their thoughts, feelings, and questions about what they heard you say. Finally, document your conversation in the employee’s file so that you can refer to it as justification for a raise or for a disciplinary process.
In a nutshell, effective feedback includes the following actions:
- Ask for the best time to offer feedback.
- Act when behavior is observed.
- Have the courage to tell the truth.
- Focus on the behavior, not the person.
- Check that feedback was understood.
Finally, to circle back to our bird metaphor, aim to be a feedback eagle, not a feedback seagull.
Editor's note: This article originally appeared in DE Weekend, the newsletter that will elevate your Sunday mornings with practical and innovative practice management and clinical content from experts across the field. Subscribe here.
