Feedback as Fuel: Transforming Critique into Growth

Amy Brann  00:00

Have you ever received feedback that made you bristle, that one comment that stuck in your mind, overshadowing all the positives? Or maybe you’ve dismissed feedback outright, thinking they just don’t get it. The truth is, feedback isn’t just about what’s being said, it’s about how our brains process it, and that’s where things get interesting. Neuroscience tells us that criticism can trigger the same pain circuits as physical injury. Behavioral Science reveals that our cognitive biases distort, deflect, or even reject feedback that could help us grow so in today’s episode, we’re diving into the hidden biases that make feedback feel personal, why our brains could resist change, and most importantly, how to train ourselves to use feedback as fuel instead of friction, from confirmation bias to the Dunning Kruger effect, we explain even why the best intention feedback can feel like an attack, and how to break through that reaction to unlock real growth. If you’re ready to stop fearing feedback and start leveraging it, then let’s dive in.

Dr. Jessie Gulsin  01:02

Oh yes, Amy. I mean, how often have I can recall receiving feedback, which, on the whole really positive, but there’s one less positive comment, and that’s what I seem to focus in on, and then I feel really deflated. So I guess what you know would be interesting for us to explore further is how we can arm ourselves against this negativity. And I’m sure organizations have asked you the same Yes.

Amy Brann  01:24

So we’ve worked with lots of organizations, specifically in the last five years, around elevating improving their feedback culture, because it is recognized that feedback can be a competitive advantage. And I know when you share with us, like how much you guys feedback and review and reflect and everything that basically gives you data on what’s gone before, how embedded it is. But so many organizations and individuals within those organizations are really, struggling with this. And I think there are some general challenges that if we could overcome those, then other stuff would be a lot easier. But I’m gonna, I’m gonna start with the the biggest thing, the biggest change I think we could all make as of this afternoon, that would help. And this is beneficial for when you’re dealing with children, when you’re dealing with people in a organizational context, or, to a degree, even when you’re teaching others how to deal with you. It can be really helpful. And that is rather than to offer feedback, ask questions, ask permission to ask questions or to have a chat, but rather than jump in with I’ve got feedback to give you, which, in this day and age, activates the majority of people’s threat response, and because the majority of people are not okay with not being perfect, then being able to even admit to something not being perfect can be a barrier. But instead of you pulling me aside Jess and saying right in that last examination, you made about 15 errors, and we’re going to go through them one at a time. If you pull me to the side and say, right, how do you think that examination went? Which I know is your style, but it elicits a completely different response from me. And then if I pick up 10 of my errors, you go, yeah, I think your self awareness is brilliant, like I love to see that you’ve that you’ve found those things, and that you know how you’re going to do it differently. Next time, I wonder, did you also notice this like and then you mentioned the other five, and they’ll and they may have and not mentioned it, or they may not have. And obviously, 15 is an awful lot. I’m not suggesting that we give 15 feedback points in one session, but in some situations, you might need it. And I mean, you come from you, you yourself. Jess have been in a world where feedback has been your norm for decades. So how have you survived it? What do you believe about feed feedback that’s enabled you to embrace it and use it as helpful building blocks?

Dr. Jessie Gulsin  04:21

Well, just as you mentioned, really, you know, it’s not uncommon, and I have been very guilty of this in my more inexperienced days of jumping to the defense, going into kind of defense mode when somebody says they want to give you feedback, you think, Oh, God, what have I done? I don’t think I’m ready to receive this feedback. But I guess in my line of work, having somebody give me some feedback is going to improve how I work, which could minimize risk to patients. So, yes, a bit more extreme an example, but I think it’s enlightening to be given feedback, because there’s a lot of blind spots that we have, so we may not even. Be aware of some of the things that we are doing that are not right, and feedback is such an integral part of the job, and something that with my trainees, we try to encourage. Not only as a trainer, do I give feedback to trainees, but I encourage them to give me feedback, and I try to make it a two way process, because I want them to feel safe, to receive feedback, and by then accepting feedback myself, it shows that I’m willing, and where it kind of puts us on the same playing field. So yes, I may be more experienced as a GP, but I’m still learning from my trainees all the time, and cases are very different, and I’m still learning from patients all the time. So I think, as well as kind of reflecting on our on our day to day, offering feedback in whatever mode you feel most comfortable doing is so important, and not only is it important, but it’s important to do it in a timely fashion. I definitely know that my brain is so buzzing all the time and I’m so busy that if somebody needs to give me some feedback, I need to have it there and then after an incident or after a particular case, so that it’s then solidified in my mind, and I’m not going to forget it. If you then give it to me a week later, I won’t, I won’t remember the case that we were talking about, so it’s not very useful. The other thing is also to be specific about your feedback, isn’t it? So I like what you say, ask questions, and I did. I definitely do this with with trainees. I ask them, you know, what went well in that scenario? What do you think you could have done differently? And then, you know, I just kind of leave. I try to lead with open questions, because I want them to provide their own feedback. They learn far more in that in that situation, than just being told. And because we all go on the defense, which is very natural, your mind switches off a little bit, and you don’t necessarily, you’re not always going to be ready to receive feedback, and that’s the other thing to bear in mind. Is this person, like you say, ask permission. Is this person to receive ready to receive feedback at the moment, or should we park it not too long in terms of timings? But should we just park it for the time being? And is this space meant to be held for just sharing the emotions that we felt at the time, so not jumping into then, you know, what did you do wrong? What could be done better next time, actually just holding space for feeling the emotions that you need to feel. And you know, I am guilty of this. It’s so easy to just react when you receive negative feedback, but taking a moment pausing before responding is also so important, and in the moment, if you don’t feel like you’re able to respond in a way that would seem polite or professional, just saying thank you for your feedback is sometimes enough to then allow you time to process what’s been said, because whether we like it or not, positive and negative feedback serves a purpose, and it’s important to reflect on both.

Amy Brann  08:11

I totally agree, and I think what something you mentioned about, they’ll remember it a lot more if they volunteered or searched for that information within themselves a lot, a lot of times. In my experience, people do know what’s not been optimal, and so could give the feedback that you’re about to give them, and if that’s ever the case, then it is much better if they can share it, rather than you sharing it with them. The reason they remember it more is you’re going to activate more networks because they networks, because they’re going to have to search. So they’re going to be more engaged. So dopamine receptors will be switched on. It’s more likely to give a nudge the air. The emotions won’t be negative and as negative and their self talk won’t be spiraling in a negative way, which will then mean that they’re able to retain their thoughts, their helpful thoughts, more effectively. So, yeah, it’s, it’s just so impactful, if we can get this done well. And other things I picked up on what you were saying. You you have this long, lasting growth mindset. You’re still learning that although you are more senior than the majority of people that you’ll deal with, that means that you’re not utilizing your status in a way that will negatively affect them or their ability to process. You’re saying, Look, I’m still learning. You’re still learning. So learner to learner. This is the light that I can shed on your blind spot. And maybe there’s light you can shed on mine, and if not, I am always looking for those lights to be shown in areas that will help me help others. So I think the other thing that you’ve got is a strong why, why you’re looking for that feedback. And you, you sort of caveated it with saying, Oh, well, in medicine, it. For this purpose, every organization we speak to has the same intention. Yes, it may not be to save lives, but it is so that they can do their job better. They recognize that there’s blind spots, and actually we can help one another see. But I wonder whether there’s something almost in that gradiated exposure, because you’ve got the classic old stories. I don’t know whether it’s still the case now, but certainly when we were at medical school, of you’d go and stand round the bed of a patient in a group of what, six or eight of us and a mean old consultant, would tear your ideas to shreds in front of the patient and your peers, if you dared suggest something that was not a sensible idea, then there could be sarcasm and all sorts that was thrown back at you. And actually, you kind of had to toughen up real quick.

Dr. Jessie Gulsin  10:53

You did. I mean, I think it’s less of a tactic employed Now, thankfully. But I have to say in those moments where, you know, I’ve, I’ve had my consultants call me, you know, demented, and one ward round, because I My memory was so bad, and I just thought that’s So Amy, see, and so awful. How could you say that? But I still remember. I still remember that experience. It wasn’t a, wasn’t a positive one, but I definitely, yeah, I learned from it. I learned to make sure I was prepared for that particular consultant. For sure, consultant for sure. Um, but I think my my junior clinician self would have always seen kind of constructive criticism as a me problem. So that was when I was less confident in myself as a clinician, whereas now I do try to have a more balanced approach and really try to dissect and reflect on what the underlying issue actually is like. It doesn’t necessarily have to be something innately wrong with me. It could be a process issue. It could be, you know, an issue with I don’t know how the day is structured, or, you know, there’s many other factors and variables that can affect what I’m doing. And if we automatically jump to that negative self thinking and that mindset of, oh, this is a me problem, then rather than actually being proactive to solve the problem where this ruminating and just feeling bad about ourselves, which isn’t productive at all, you’re allowed some time to have a whinge and have a little moan to your colleagues, and that’s allowed. You know, it’s cathartic to do that, but then, as time has gone on, I definitely am getting better at having my 32nd moan and then thinking, right, okay, so what is the real issue here, and how can I try to address it? So I think either way, it’s an important aspect of growth and feedback is something that we should all be welcoming with open arms.

Amy Brann  12:49

So what would be other ways to down regulate that immediate negative response? We definitely don’t want everyone to have to go through the bedside dressing down in order to have enough exposure that they’ve learned to process it in a way that they can survive through, because not everyone is so lucky. But So what’s what are the other ways that we can affect so certainly, one of the things that we really recommend is the positioning around The feedback, the shared intentionality, the inviting buy in and and then the coaching approach ahead of the pure feedback. That approach. That doesn’t mean that we never give pure feedback, but it does mean we check whether or not the person we’re about to give it to knows what we’re going to say, because then it’s unnecessary. Um, I think the

Dr. Jessie Gulsin  14:04

from the the first thing that I have tried to do as I’ve developed as a clinician is to just try to see feedback as an opportunity, so not try to attach any emotion to it necessarily, but just seeing seeing it as purely a practical thing that could help me do better, and by removing the emotion from it, in some ways, it makes you feel like you’re less on the defense, and then you’re more receptive to hearing somebody’s feedback on your performance. Because the other thing I guess, that we need to bear in mind and reflect on is when we’ve given feedback to somebody, I’ve even asked trainees specifically, how was my feedback, by the way, you know what? Because what I don’t want to do is be overly critical and then choose. Go even more defensiveness, because you don’t want to feel like you’re being attacked all the time. So just being open again to learning from how you’ve fed back. You know, I’ve had instances where feedback hasn’t gone very well, and I may have inadvertently upset somebody, which I you know, I am absolutely mortified if that ever happens, and I would never want that to happen again. And so therefore, learning from those interactions of doing it wrong is also so important,

Amy Brann  15:31

yeah, and learning what how to work with different people, I’ve certainly had a lot of more senior people say to me over the last year specifically that their experience is giving feedback in a way that’s accessible for people has become more difficult recently, which is is interesting and needs a response to I think It will be part of a bigger systemic challenge, but your approach, yeah, of meeting people where they’re at and working out what you can what you can do, and how you can do it. But it’s again, it comes down to your you’re seeing it as an opportunity. You’re seeing it as data and and you’re not taking it personally, which I think is a difference in a lot of organizations. And I’m sort of pondering over whether it’s part of that, because there’s a lot of the feedback you would have been given will be on what you’re doing, wouldn’t it, rather than how you’re doing it, unless your clinical procedures, then it could be how, but is, is it more on the technical side of things, rather than, like your your bedside manner, for example, that’s always been pretty there’s been less that needs to evolve from that perspective, whereas clinical knowledge and oh, Did you check that? Or did you check this? That there was probably more opportunities for learning there in your early career, it’s up.

Dr. Jessie Gulsin  17:08

I think there was a default presumption that you just had to know the clinical stuff. You know. You either know it or you don’t. And if you don’t know it, then it was very obvious. It’s all the the other more softer, kind of subtle skills that I’ve developed gradually as time has gone on, for example, Breaking Bad news to a patient or their family members, that has taken years of honing and and you know, to get it right. It takes a lot of skill, and it’s very easy to get it wrong. And so in situations like that, I guess I’ve been quite proactive in asking other people to observe what I’m doing and not to be afraid of somebody to tell me that I’ve not done it very well. Nobody wants to hear that they’re not very good. And I guess we all like to think that we’re good at stuff, and especially high achievers and people in positions which have they’ve worked really hard to get to that point. It’s understandable to be a bit resistant to wanting to hear that you’re not very good, even if it’s coming from a good place. So what we need to do is, I guess, share in the situation and work together to be able to improve skills. Again, it’s a two way it’s a two way street, isn’t it?

Amy Brann  18:40

It it is. But what I find fascinating again, which I think is it really wise, is you’re activating your perception of control by asking others for their observations. So you know, take breaking something like bad news, you are making life more difficult for people if you break that news in an unhelpful way. So that could really be triggering to some individuals of oh, gosh, I really am not doing a good job. I’m not being helpful right now. And a lot of medics really want to help and want to be helpful. So that could be incredibly jarring for someone’s identity, but you were proactively going out there recognizing it as important, proactively going out there to look for input criticism on how you could do it better, like, what, what? What needs to be improved still, and so I’m just sort of wrestling with, is it just because you’re an unusual human, or is it, is that a strategy, then that could be mapped across, and I think it could be mapped like others could utilize that strategy, but a key piece could be that you were asking for that feedback, so you. Didn’t believe that you were useless or rubbish because you weren’t, because there were things to learn about it.

Dr. Jessie Gulsin  20:05

No, I didn’t think I was useless or rubbish because, you know, I’m an innately a kind and compassionate person. But you know, if you’ve never done something before, then I guess it’s about having a bit of humility and being humble and appreciating the fact that you’re not gonna know everything. So, you know, I, I guess I’m classic personality of kind of imposter syndrome and being under confident in my early career, which probably made it more likely that I would ask for feedback and ask for people to observe me so overconfidence isn’t, isn’t a good thing, but I don’t know. I think it’s, it’s just a case of wanting to do better for people. I just wanted to, I wanted to do it well, because I know that patients and family members, they hang on your every word, and especially in moments like that, when there’s end of life discussions happening, those are things that are going to be with somebody for the rest of their life. And I guess if you want to kind of draw parallels to other industries, I mean, yes, again, this is quite an extreme example, but the way that somebody’s given feedback, or the way that you have a discussion about something which is a bit sensitive, could really impact somebody’s perception of themselves, and then, unfortunately, impact the way that they work thereafter. And so it is really important that you have insight into that side of yourself and those kind of quality that you may possess, and it’s therefore a good thing to welcome feedback,

Amy Brann  21:47

Yep, yeah, in those safe spaces, encourage ask questions. Directionalize it, you know, get clear on what you’re actually looking for, what you’re looking to develop at different stages in in your life. So, yeah, I think you know, the filters that you’re using to then hear the feedback. We’ve really hurt, we’ve really heard, looking at how you emotionally regulate during that experience, you know, preparing yourself, or, as you say, if it’s something that you really don’t trust yourself to respond to then just thanking the person and having some kind calm time making sure that you’re seeking to understand during those interactions. And I’m really in and just I’ve heard very clearly that how you see feedback is really, has really influenced your motivating behaviors around it. And I love you know that that frame of No, no, I know who I am, but why would I be good at something that I haven’t done yet? Almost, and in a lot of organizations, people are doing things that they’ve not done in this way, in this context before, and so we’ve got a really strong permission base to be seeking this feedback, input, just all being in it together to look at things. So a couple of the biases that can play into feedback and make it more difficult, perhaps, for us to explore things. One is obviously the confirmation bias, so we are more likely to seek out information that confirms our existing beliefs, go to people who will say what we want to say. And I’m fortunate that I’ve got friends that won’t just say what I want to say. Sometimes, if I tell them I really want you to say this, then they’ll decide whether or not they will endorse that message or actually say no. Amy, I just don’t think that’s the way forward. So I think that’s really important to be aware of the negativity bias, if, as we’ve sort of said before, if we’re a negative attribution bias, if we’re going through a really tough time, then it might be more difficult for us to hear positive builds constructive way forwards that negative feedback, as you said, you know wrong in your ear you’ve been aware of for years. That is what can happen. And so preparing our state and maybe even being open with those around us, you know, what we feel that we can tolerate, or how we can tolerate it at the moment, could be different this Dunning Kruger effect, which you’ve referenced, but without sort of labeling it, people with lower competence in a skill over often overestimate their ability. They have overconfidence, which can make them less receptive to feedback, and we might dismiss things that really we should be leaning into and wondering. Yeah, what we can do. And I mean, self awareness, it sounds like could be quite important around this. Would you say?

Dr. Jessie Gulsin  25:12

Oh, absolutely. So in in kind of my tutorials, we often talk about something called the Johari window, where we’re trying to identify our own blind spots. And it’s a psychological tool which is used to increase levels of self awareness and self understanding. And it’s a two by two matrix, and each quadrant represents a different level of self perception. So there’s the unknown quadrant, which is the most difficult one to uncover, but has the most potential for discovery and growth, and it’s those, you know, those things unknown to self and others, which are the things that we need to try and uncover. But having insight is one thing, and it’s important to have feedback from others so that you can try to uncover those insights. But if you’re not receptive to it in the first place, if you think you’re very you know you’re very competent in something, and you’re overestimating your abilities, and you’re never going to uncover your blind spots, because you’re just not going to be open to receiving any kind of cues or pick up on any clues. So yes, being confident is important, but there’s a balance, isn’t there?

Amy Brann  26:20

Yeah, absolutely, yeah. And we’ve seen the power of humility before. Be a real tool for people, and I think it is still at all in humility, whether we’re asking to receive it or offering it to others, you know, acknowledging our own vulnerabilities or being our own weaknesses and being vulnerable enough to share those with someone could be a great in especially if there’s something more difficult to discuss. If you know, being empathetic people we feel for, for those that we’re giving information to, if they’re not aware. You know, it’s one thing to coach someone, but there are absolutely times where someone’s got no idea that they are coming across in a hugely unhelpful way, and we’re going to be the ones to break it to them. And so being able to be compassionate and make sure that they are connected to the reality that they are not perfect. None of us are perfect like you’re we’re all in the same boat in this regard. Yes, this is your current weakness and something you need to work on. But don’t think that Bob down the road hasn’t got his own weaknesses that he’s working on, or, you know, Sarah over in accounts, hasn’t got her things that she’s working on to normalize that a little bit and perhaps reduce the idea of, you know, the comparisons that we naturally do that again could be unhelpful. Okay, there’s lots and lots of other biases that we could mention. I think possibly the last one that I really want to make sure we’ve spoken to is this reactance bias. So if we feel that our autonomy or freedom is being challenged, we can resist and again, I think that’s one of the reasons that that people can push back on things. So if we can do it in a way that elicits autonomy rather than restriction, that can just work with the brain rather than against it. But, oh yeah, lots of research on this one. Definitely check out the spark sheets, um, and unpack some of the other ways. Was there anything else you wanted to say? Jess, I know I

Dr. Jessie Gulsin  28:35

was going to say there are helpful biases as well. Biases as well. But obviously we don’t have time to go into that now. But there is a lot to unpack in this particular

Amy Brann  28:44

subject. Yeah, you’re right. What would be one of your helpful biases that you want us to just be thinking on?

Dr. Jessie Gulsin  28:52

Well, I guess thinking about a clean slate and wiping the slate clean, using this as an opportunity to think, Okay, well, that really didn’t go very well. Let’s wipe the state clean, accept some feedback, and then start afresh.

Amy Brann  29:07

And then the one that I’ll share, just because I love the name of it, is the practical effect, which is about how those of us that can accept our imperfections, we typically are more likable and adaptable than others. So when competent people admit to making mistakes or having weaknesses, it can be really beneficial, and it can facilitate other positive, pro social type behaviors within a team. So yeah, embrace the imperfections. Don’t, settle with and certainly we’re extremely grateful for our medics and other people in really important jobs to constantly be reinvesting in themselves and exploring but really grateful for some of the positive frames that you’ve shared Jess because they just at. They help us to see, okay, well, how, how is someone that is engaging with feedback on a daily basis for you know, over two decades? How are they doing it? You know? So it’s good to tap into your brain. So if you have enjoyed today’s brain tappings, then please share it with a friend or colleague who might find it helpful, because it’s one of the best ways to help us grow and reach more people like you, then

Dr. Jessie Gulsin  30:23

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