Context In our role as postgraduate medical education (PGME) fellows, we designed and delivered an hour-long feedback conversations workshop with our Trust’s Leadership and Development consultant, to a multiprofessional faculty leadership group, Helping Our Teams Transform (HOTT) at our Trust. This group uses human factors and team building to improve safety, effectiveness, and efficiency within healthcare teams.

Issue/Challenge Our NHS staff survey[1] showed that managers gave feedback 60% of the time and the national best is 70%. Receiving regular feedback has been shown to improve engagement of teams and patient safety outcomes[2]. It is through feedback conversations that clinical leaders can also enhance their reflective practice on their leadership style and impact[3] to achieve excellence in patient care.

Assessment of issue and analysis of its causes

The literature shows that team leaders require effective communication skills to engage in feedback for continuous improvements[4,5], in healthcare teams. Furthermore a recent study, on feedback by the General Medical Council (GMC) recommends, ‘feedback should be a two-way developmental conversation and to raise awareness that this is the expected standard of feedback’[6] Our collaboration with the HOTT faculty, Leadership & Development, and PGME departments allowed constructive alignment for the development of this workshop to effectively equip leaders with skills and strategies for high quality feedback conversations.

The feedback conversations workshop outlined principles of inclusivity, growth mindset, psychological safety and a feedback model called Situation, Behaviour, Impact (SBITM)[7]. The workshop was underpinned by our Trust values and links to other resources available at the Trust to facilitate feedback conversations.

Impact The workshop was followed up by an immediate and a one-month follow up online survey, using Kirkpatrick evaluation[8]. The one-month post workshop survey evaluated whether the workshop resulted in change in attitudes and practice around feedback conversations.

Intervention Immediate post workshop evaluation: Response rate was (11/11). On a 5-point Likert scale the participants rated their confidence in feedback conversations as much higher (median=5). The knowledge of the growth mindset (median=4), psychological safety (median=4) and SBITM model (median=4) was rated higher immediately following the workshop.

One-month post workshop evaluation: Response rate was (4/11) 36%. On a 5-point Likert scale all respondents (n=4) rated their confidence in feedback conversations as higher (median =4). Respondents reported higher quality of feedback conversations with patients and colleagues (median=4) and were more likely to have applied the growth mindset (median=4), psychological safety (median =4) and SBITM model (median=4) in their feedback conversations.

Common themes regarding respondents change in attitudes towards feedback conversations following the workshop included: appreciating that feedback is a two-way conversation and promoting a culture of feedback. Common themes regarding respondents change in practice following the workshop included: seeking more feedback and engaging in more feedback conversations.

All participants felt motivated to practice feedback conversations immediately following the workshop (n=11) and one month later (n=4).

Attitudes and practice around feedback conversations changed one-month following the workshop, with greater emphasis on creating a psychologically safe and growth mindset orientated feedback culture, which will allow continuous development of faculty leaders who are involved with improving team performance and safety at our Trust. This workshop design may help guide other Trust’s to promote quality feedback conversations to raise standards nationally.

Key Messages Our workshop was effective at promoting feedback conversations in a multiprofessional group of faculty leaders, as confidence and motivation to have feedback conversations was increased and sustained one-month after the workshop. Furthermore, there was a positive change in attitudes and practice around feedback conversations in our faculty leaders, which will allow them to achieve their team goals in providing efficient, safe, and holistic patient care.

Lessons learnt Our work is in progress. We are aiming to implement this workshop Trust wide in a sustainable manner in terms of personale and cost-efficiency, to promote high quality feedback conversations.

Measurement of improvement Effect of improvement will be measured by annual NHS Staff survey, GMC training survey and longitudinal follow up of participants of the workshop.

Strategy for improvement High quality feedback conversations need to occur at all levels across the Trust. Therefore, through the collaboration of the PGME and Leadership & Development departments this workshop will be implemented Trust wide into various programmes. Further adaptations to design and delivery will be achieved by sequential plan, do, study, act cycles.