American Association for Physician Leadership

Team Building and Teamwork

Feedback: A Cure for Uniformed Resistance

Robert Hicks, PhD

January 8, 2020


Abstract:

In my article “overcoming resistance to change,” I shared that resistance to change might be caused by a lack of awareness of the need for change. To this point, a person may be unaware of the impact his or her behavior has on others. Alternatively, a person may be aware of potentially problematic behavior but downplay its significance.




In my article “overcoming resistance to change,” I shared that resistance to change might be caused by a lack of awareness of the need for change. To this point, a person may be unaware of the impact his or her behavior has on others. Alternatively, a person may be aware of potentially problematic behavior but downplay its significance.

In either case, there is a lack of motivation to begin a change process. This is called the precontemplation stage of change,(1) and coaching is ineffective in this circumstance. Only when people realize that it is in their best interest to change do they move from the precontemplation stage to the contemplation stage of the change cycle. Although coaching is most beneficial at this stage, that does not mean you can’t help a person who is in the precontemplation stage. It just means that you must help him or her based on your role as a leader, mentor, colleague, or even a friend by providing feedback that raises their awareness of the need for change.

According to McShane and Von Glinow,(2) “Feedback is any information that people receive about the consequences of their behavior” (p. 153). Although feedback can be considered a form of education, there usually is a different subjective reaction to information when it comes from the observations of other people rather than an objective, impersonal source, such as a workshop or a book. Feedback that originates from other individuals, such as a superior or peer, is referred to as evaluative feedback.(3)

For example, suppose a physician learns from a supervisor that his or her colleagues consider the physician’s interpersonal style to be abrasive. He has received what is known as evaluative feedback. Evaluative feedback often comes as a surprise and may trigger a defensive response, regardless how accurate the feedback. If the person becomes defensive, he will not accept the feedback and it will have no constructive impact.

Generating A Positive Response

The probability that a person will respond positively to feedback is determined by three factors: 1) how accurately the feedback is understood, 2) the degree to which it is accepted as valid (an accurate portrayal of his behavior), and 3) the recognized value of what is learned from the feedback.(4)

1. Comment on Behavior, Not Intentions

When giving feedback, remember what A.C. Daniels says: “As unbelievable as it may sometimes seem, every person’s behavior makes sense to them.” (5) (p. 32) A person’s intentions are private and unspoken. Ascribing motives to the behavior of other people will put them on the defensive, causing them to focus their energies on justifying their actions rather than reflecting on their behavior.

When providing feedback about a person’s behavior, describe what you have observed objectively and in a neutral tone. Think of yourself as giving a verbal video of what you have seen, without judgment. Present the natural, logical consequences of the person’s behavior based on cause-and-effect reasoning or what you have observed directly. Be descriptive and non-evaluative and maintain an Adult ego state.(6)

2. Be Specific About Behavior

Feedback must be specific so the recipient perceives it accurately. A positive response depends on the person’s ablity to pair the feedback with a particular behavior. If you were to say to a physician, “You’re heavy-handed in the way you get things done with your colleagues,” not only do you risk coming across as judgmental, but without more specifics the feedback is not particularly useful. For example, what exactly does the physician do that comes across as “heavy-handed”? Without a specific behavioral reference, the term “heavy-handed” may mean something totally different to that person than it does to you. Such a discrepancy in definitions risks a “that’s not true” argument.

3. Make Feedback Relevant

A person may understand the feedback, but not its relevance. Feedback is relevant only when the person recognizes it as personally or professionally important. Importance is the value a person places on the information and determines whether he or she will act upon it.

If the physician whose behavior is perceived as abrasive does not attach any significance to the complaints of colleagues, he or she has no motivation to act on the feedback. Finding a way to help the person see the relevance of the feedback is critical to motivating change.

4. Ensure Credibility

All feedback originates from a source, and while the source is not part of the feedback, it is often difficult to separate the two;. therefore, acceptance of the feedback depends as much on the source of the feedback as it does on the content. The most influential characteristic of the source is its credibility. Credibility determines how much influence the source of the feedback has on the person receiving it.

Credibility is very much a function of trustworthiness.(7) “Can I trust what this person is telling me?” If others do not perceive you as trustworthy, they might very well raise questions about your true intentions, for example. This might create a level of suspicion that could interfere with the person’s receptivity to the feedback — even if the feedback is accurate.

Trustworthiness depends on the perception of good intentions. When giving feedback, your good intentions must be apparent.

References

  1. Prochaska JO, Norcross JC, DiClemente CC. Stages of Change: Prescriptive Guidelines. In Koocher GP, Norcross JC, and Hill III SS (eds.). Psychologists’ Desk Reference, 2nd ed. New York: Oxford University Press, 2005, pp. 226–31.

  2. McShane S., Von Glinow MA. Organizational Behavior, 3rd ed. New York: McGraw-Hill/Irwin, 2005.

  3. Podsakoff PM, Farh J. Effects of Feedback Sign and Credibility on Goal Setting and Task Performance. Organizational Behavior and Human Decision Processes. 1989;44(1): 45–67.

  4. Ilgen DR, Fisher CD, Taylor M S. (1979). Consequences of Individual Feedback on Behavior in Organizations. Journal of Applied Psychology. 1979;64(4):349–71.

  5. Daniels AC. Bringing Out the Best in People: How to Apply the Astonishing Power of Positive Reinforcement. New York: McGraw-Hill, 1994.

  6. Hicks RF, McCracken JF. (2010) Coaching from an Adult Ego State. Physician Exec. 2010;36(5):80-82.

  7. Hicks RF. Coaching as a Leadership Style: The Art and Science of Coaching Conversations for Healthcare Professionals. New York: Routledge, 2014.

Robert Hicks, PhD

Robert Hicks is a licensed psychologist, a clinical professor of organizational behavior, and founding director of the Executive Coaching Program at the University of Texas at Dallas. He also is a faculty associate at UT Southwestern Medical Center and the author of Coaching as a Leadership Style: The Art and Science of Coaching Conversations for Healthcare Professionals (2014) and The Process of Highly Effective Coaching: An Evidence-based Framework (2017). robert.hicks@utdallas.edu

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