The Role of The Feedback in The Internet

True leadership implies flexibility in terms of vision and strategy. Buzzwords include feedback, performance review, and 360-degree reviews. The focus and main issue with these methods is an emphasis on, what’s not going well with a focus on the past. Feedback typically is dreaded and carries a negative perception, inflexibility and an uncomfortable feeling of what one may have done wrong. Since feedback does not allow for recipient participation, the end result is typically a defensive stance. Feedforward, on the other hand, focuses on creating & improving the future and draws a path to a future goal. We can ourselves create the future by asking for suggestions, listening to new ideas and simply improving our listening ability, in essence, moving from good to great! As radiologists are being thrown into more challenging situations, with an ever-increasing workload, inter and intra-departmental pressures and declining reimbursements, a negative performance review, negative feedback or perceived criticism can be the last straw, leading to rising friction and lack of camaraderie in the workplace as well as feelings of lack of self-worth. Possible questions in feedforward may be: What are some things that you do well in terms of everyday imaging? What are the key areas of improvement with respect to managing your team? What specific changes can help you in future professional development? What changes can you make in communicating & interactions with your peers and team? The concept of 360-degree feedforward is exciting, flexible and insightful, since its focus is on future performance, with an emphasis on positive improvements and qualities.

Identifying priorities with a focus on monitoring, mentoring and mapping at the same time widening our horizon in line with organizational objectives. A future, “pat on the back” so to speak, it provides insight into positive qualities, ones you possess and those you can improve upon further. Its potential impact can thus only be positive!

Feedforward is a process in which the participant asks their colleague, leader or junior trainee actively for a couple of specific ways in which they can improve in order to have a greater impact/added value to the organization or department. Furthermore, unlike feedback in which the person being evaluated feels cornered and defiant, feedforward asks for active participation from the recipient. In a sense, as humans, we tend to activate the defensive portion in our brain while receiving feedback but may realize the open, non-defensive part of our brain while receiving feedforward.

Marshall Goldsmith’s golden rules of Feedforward:

1. Identifying behaviors which if changed can cause a positive change in the future. Example: Need patience with clinician telephone calls or, need to slow down while looking at cases.
2. Ask a colleague for a couple of suggestions that you could use in the future. Describe a goal to someone, even if it’s someone you have recently met. They do not need to know anything about you for this activity to be successful.
3. Ask this person for two suggestions that you could use in the future that would help you achieve the behavioral goal you’ve described. If you know the person, Goldsmith, notes that “the only ground rule is that there can be no mention of the past.” The person then offers their two ideas.
4. Listen carefully to the suggestions and take notes if you wish. The final rule is that you must not comment in any way other than to say “Thank you.”

Repeat the process with other people until you have all the suggestions you want or need or until the ideas begin to repeat. Eventually, some feedback for the feedforward may be solicited from the recipient but it will be at their pace and at their bidding.

An example of feedforward in Radiology would be a faculty member asking for feedforward from a colleague for two areas of personal improvement. Q: Do you have two suggestions for me to improve as an academic radiologist? A: Here’s how you can improve your teaching score. One way is to come in and first thing in the morning, show 3 unknown cases to the residents on your service, a 10-minute exercise, this will really stick in the resident's minds and make you a better teacher. Another way is effective praise: “I really enjoyed/learned a lot from the article you co-authored in AJR”. It would be great to see you write more focused papers on liver imaging as the first author, to build on your resume and develop a niche in an area that you’re passionate about.