By Tyler Reimschisel, MD
In the Tips for High-Impact Teamwork columns this summer, I have been discussing feedback. In May, we reviewed general principles about feedback. One of the most important concepts about feedback that I want to reiterate is that we should approach giving and receiving feedback with a growth mindset so everyone tries to learn from the interactions, including those receiving the feedback as well as those providing the feedback. Last month, I compared and contrasted three types of feedback: destructive, constructive and deconstructive (see Kegan, 2002). Based on my professional experience and perspective, I think deconstructive feedback is an excellent approach to feedback, and I have found it to be very impactful when I have provided and received feedback as well as when I have mediated disagreements between individuals or within a team.
As you may recall, we use the term “deconstructive” because it disassembles the specific situation or event into discrete and observable data. “Observable” data is that which could be recorded with a video camera, and it includes verbal and nonverbal communication. Therefore, the person providing deconstructive feedback focuses on observable data when giving the feedback. They do not primarily focus on the recipient’s thoughts or attitudes since those aspects of the recipient cannot be recorded by a camera.
At the conclusion of last month's column, I mentioned that I have heard concerns or overt resistance to this approach, though only by individuals who have never practiced it. This month I would like to address those misgivings.
The most frequent concern I hear about using the deconstructive approach is that it seems like it takes a lot of time. I would like to use the deconstructive approach to provide feedback about this criticism toward the deconstructive approach. When someone says that the deconstructive approach to feedback will take too long, I like to ask more questions about the basis for that perspective. Have they tried it and found it takes a long time? If so, how long did they practice it before deciding it was too time-consuming? In my experience, every new skill, including giving feedback with a new mindset, takes time to learn how to do it well and efficiently. Typically, they have never tried it, and the concern is based merely on conjecture about how long they presume it will take to provide effective deconstructive feedback. In that case, I simply offer evidence from my personal experience with this approach. Although it will take some time to learn this new skill, it does not necessarily take any longer than any other type of feedback. Furthermore, it is much more respectful, productive and educational.
Another concern I hear frequently from leaders is, “We can barely get our clinical staff to provide any feedback, let alone deconstructive feedback.” Again, before I respond to this feedback, I would like to know more about what is generating this perspective. I may ask the leader to explain why they think deconstructive feedback would be an even harder format for their staff to use. Maybe the concern is again about time and how long it would take their staff to learn a new approach. If that is why they are voicing this specific concern, then I would provide more information about my experience, how I suggest teams begin using this approach and the benefits I have seen when teams invest time in practicing deconstructive feedback.
Alternatively, maybe the concern about expecting staff to use deconstructive feedback is based on the staff's negative view of feedback in general. Perhaps the leader doubts the staff will take the time to genuinely invest in learning a new approach given the unfavorable reputation that feedback has within the office, clinical unit or team. If this is the situation, then this concern supports the view that the current approach to feedback is significantly problematic and a new approach is warranted. Devoting time as a team to learning and implementing deconstructive feedback can help mitigate the negative perspectives individuals have about feedback. Plus, more effective feedback has the potential to enhance team impact, leading to improved personal capacity and job satisfaction, better internal team dynamics, higher quality of the team productivity and greater positive impact on the systems in which the team functions.
Another complaint I hear about deconstructive feedback is that its emphasis on dialogue or discussion can appear to minimize or devalue the expertise of an experienced clinician, educator or leader. Traditionally, feedback is commonly viewed as the hierarchical process in which an all-knowing supervisor shares their knowledge, experience and perspective with the recipient of the feedback, and the recipient should be grateful to have received the "gift" of help from the supervisor. However, deconstructive feedback is more egalitarian, and it carefully considers the viewpoints of all individuals involved, including those who may appear to be less knowledgeable and less experienced.
I don't think these situations are necessarily mutually exclusive. In deconstructive feedback, the supervisor can describe the experiences and knowledge that is informing the feedback they are providing, thus recognizing the merits of their insights. In addition, deconstructive feedback also places value in the perspectives of those who are apparently less experienced and less knowledgeable because their lived experiences also have merit and can still be a source of learning for the person providing the feedback. The upshot is not that everyone’s perspective is of identical value but that each person’s perspective has an important value that should be considered during the feedback process.
In addition to addressing the typical concerns that I hear about deconstructive feedback, I also want to discuss some of the additional benefits that I have found with deconstructive feedback. For example, regardless of the model of feedback that you prefer, one of the most challenging aspects of feedback is giving feedback on nonverbal communication. Most of the time, we fail to give feedback on nonverbal communication because we simply don’t know how. But the deconstructive approach is very helpful in this situation. To begin, the person or team member providing the feedback simply uses a nonjudgmental tone to put into words the nonverbal behaviors that they saw. For example, "I noticed that as I was reviewing this patient complaint with you, you appeared to roll your eyes and fold your arms. Did I characterize that correctly?” If the person receiving the feedback agrees with the characterization of the behavior, then the team member continues using the deconstructive approach by saying, “From my perspective that nonverbal communication seemed to me to be dismissive or defensive. What did you mean when you rolled your eyes and folded your arms?"
With this approach, the team member first states what they saw and confirms that they represented it correctly. Then they transparently explain the evidence (roll of eyes, folding arms) that led to their interpretation of the person's attitude (defensiveness or dismissiveness). This approach is direct, but it doesn’t run up the ladder of inference and jump to conclusions or judgments about the person’s attitude without first openly explaining the rationale for those conclusions or judgments. It deconstructs the situation, puts into words the nonverbal behavior that could be recorded by a camera, explains how that behavior was perceived and asks a question to engage the other person in a dialogue about the behavior. The focus remains on the behaviors themselves, not on how that behavior was interpreted.
Lastly, deconstructive feedback can be very useful when addressing a pattern of behavior. First, the person providing the feedback relates each independent example of data that they believe will establish a pattern of behavior. Once each instance is briefly discussed independently, the person providing the feedback can point out that from their perspective the compilation of the examples establishes a pattern of behavior. They can then provide feedback about the pattern of behavior. Although this approach may seem tedious or time-consuming, in the long run, it is much more effective than starting the feedback with over-generalizations like “You always...,” “You never…,” or “There you go again!” It is much more productive because the focus remains on the specific examples and the pattern of behavior, not on unsubstantiated generalizations or judgments that will distract from the conversation about the behaviors themselves.
I encourage you to try using the deconstructive feedback approach in your professional and personal lives. With practice, I am confident that you will become efficient and effective in giving and receiving feedback. In addition, I think that this approach will enhance your relationships with your coworkers, colleagues, friends and family as they experience the merits of having their perspectives and experiences valued and respected, especially when they are different than your own. Please feel free to email me at firstname.lastname@example.org with your questions about deconstructive feedback or to share your experience trying out this approach.
Kegan, R. and Laskow Lahey, L. How the Way We Talk Can Change the Way We Work. Wiley & Sons, 2002.