Art critique

Receiving feedback and criticism is a complicated art

In the middle of the 16th century, surgical education was that of a real apprenticeship. The student learned by direct observation and imitation of a skilled and experienced surgeon. It was not until the early 20th century that surgical education evolved into a formalized and structured curriculum.

William Osler, MD, CM, introduced the concepts of specialist clerkship and bedside rounds in the late 1800s. Graduated autonomy, introduced by William Stewart Halsted, MD, in the early 1900s, became fundamental in the development of young surgeons. At the root of this training is the importance of feedback and criticism. Both propagate the personal improvement of the young surgeon in an ever-changing field.

Nevertheless, comments often have a negative connotation. As trainees, we often feel that receiving feedback means we are less surgeons, incapable or unworthy. But as common and expected as criticism is in surgical training, trainees do not learn to receive and manage feedback. In a stressful environment like residency, where personalities can be demanding and standards high, it’s important to be comfortable receiving and managing feedback.

Getting feedback starts with listening. The art of listening is hearing a person’s words without making assumptions. He focuses on the message to recognize a new perspective, rather than listening to respond or defend himself. The nuances of a commentary can easily be misinterpreted when the receiver isn’t listening completely. The second part of listening is understanding the message. Asking questions is crucial. As an intern, if you approach someone for feedback, be specific about what you are looking for.

Being receptive to feedback means accepting uncertainties. It is important to be receptive to new ideas, opinions and strategies from the start of the training. An essential part of growth in the early stages of a surgical career is building a repository of techniques to meet new challenges. As a senior resident, being open means recognizing the opportunities of different approaches and understanding why one may be more important than another.

Just as it is important to master the receipt of comments, it is necessary to consider who provides them. Does this person have the qualified experience to provide this feedback? Did they see the whole situation? Do they have an interest in your development? Do they have your best interests at heart? An important part of thinking about reviews is filtering who should provide reviews.

The residence is difficult, and the residents do their best to meet its demands, but sometimes we fail; we forget, neglect efficiency and make mistakes. But the goal of good feedback is not to know who you are, but rather what you did. Once we have listened, understood and maintained an open mind, we can respond appropriately.

A response begins before speaking; it starts with body language. Body language can communicate receptivity. Be aware of facial expressions, body movements/postures, gestures and eye contact. Body language can convey as much as a verbal response. Use it to reinforce your appreciation and recognize that feedback generates an opportunity for improvement.

After going through the steps, the door is open for clarification and further discussion of the area(s) of improvement. In my experience, there is immense value in these conversations. These dialogues can reveal blind spots, provide insight, and speak to your ability to learn. Reflecting on comments is the most overlooked aspect of receiving them. In what other situations can I use this tip? Should this change my way of practicing? Should I seek other thoughts or another opinion? After receiving feedback, it’s worth thinking about how this should impact your maturation as a doctor.

As higher medical education continues to innovate in the development of young physicians, the cornerstones of graduate autonomy and feedback will continue to be essential aspects of its infrastructure. Residents need to understand the role criticism plays in their growth and how it should be handled.

Ultimately, our profession is charged with lifelong learning. Our commitment to this role means a commitment to our patients and an effort to provide them with the standard of care. Being able to do this means responding positively to feedback, being open to learning new things, and having the courage to change and adapt.

Toba Bolaji, DO, is a surgical resident and can be reached on Twitter @tobabolaji.

This post appeared on Kevin MD.