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Leadership How to marry the formal review process with a true culture of feedback 6 ways to strengthen your performance review process By Claire Hughes Johnson and Anna Oakes Share to X Share to Facebook Share to Reddit Share to Email Share to Link Add Quartz on Google Share to X Share to Facebook Share to Reddit Share... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.621 | 0.712 | ["philosophy", "leadership"] | 456 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.536902 | [
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formance reviews in favor of continuous feedback. Although I do believe continuous feedback —in both directions—is a hallmark of a strong employee-manager relationship, I don’t think it should replace a written document. Done right, a formal written review is a summary of ongoing feedback conversations and a good place... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.368 | 0.838 | ["management", "philosophy", "networking", "llm"] | 459 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537277 | [
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all managers are delivering continuous feedback. The written review process will catch those cases where not enough feedback is shared. Alongside the written review process, you likely have a mechanism to assign employees a performance designation or rating and submit people for promotion to the next job level. If you ... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.612 | 0.864 | ["philosophy", "management", "career"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537369 | [
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d performance rating processes are still taking place in some form (hello, quiet firing). They’re happening behind the scenes—often without the knowledge of the person being “reviewed.” If employees discover this is happening out of sight, it can undermine trust. Instead, your assessment and recognition processes shoul... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.477 | 0.852 | ["philosophy", "education"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537420 | [
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in the performance assessment system, people need to know how they will be measured, that the measurement will be considered fairly, and how results will lead to recognition and reward (additional responsibility, promotions, or compensation increases). To do this, you need the following: A talent strategy —this could b... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.466 | 0.852 | ["philosophy", "salary", "war_conflict", "strategy", "negotiation"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537481 | [
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eement on how to assess results against those rubrics A program to capture performance feedback and promotion nominations via written and numeric assessment A clearly communicated process for calibrating performance assessments across teams so that individuals know there’s a system in place to equalize the treatment of... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.656 | 0.71 | ["philosophy", "communication", "management", "salary"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537531 | [
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for the performance and promotion processes to feed into any compensation outcomes Managers play a critical role Managers play a critical role in ensuring the process functions as it should and that the components of the review process are clearly communicated to and understood by direct reports. If you’ve managed and ... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.477 | 0.696 | ["management", "communication", "salary", "philosophy"] | 481 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537603 | [
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tions you’ve already had with your direct report. Ideally, if they’re performing well, you’re also marking a moment that results in a formal reward like a promotion, a raise, or a cash bonus. In my book, Scaling People, I devote one of the longest chapters to feedback and performance mechanisms. That’s no accident. Exc... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.424 | 0.86 | ["philosophy", "management", "war_conflict"] | 476 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537653 | [
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eir reports in performing at their highest level. But it’s also some of the most rewarding work you’ll ever do. During my move from Google $GOOGL to Stripe, I remember packing up some personal items from my desk and coming upon an envelope full of handwritten notes from people I’d managed over the years. I thought abou... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.559 | 0.87 | ["management", "war_conflict", "philosophy"] | 496 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537701 | [
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it affects their lives and trajectories for good. You never know when all the time you’ve put in to help someone be their best will pay off—but when it does, months or even years later, it can mean everything. Maybe to them, but definitely to you. Claire Hughes Johnson is one of Forbes’ ‘Self-Made Women’ of 2022, who i... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.359 | 0.886 | ["leadership", "management", "salary"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537757 | [
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leader and manager in a high-growth environment. Including actionable strategies for interviewing, navigating crises, and running a truly successful meeting, it reveals exactly how to build a company that’s set for long-term success. She also includes valuable tips for expanding your own career. 📬 Sign up for the Dail... | https://qz.com/how-to-marry-the-formal-review-process-with-a-true-cult-1850295325 | How to marry the formal review process with a true culture of feedback | qz.com | unknown | false | 0.405 | 0.8 | ["leadership", "management", "career", "interview"] | 326 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.537805 | [
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us | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.291 | 0.452 | [] | 2 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.757879 | [
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Mastering Difficult Conversations: Essential Skills for Effective Leadership FAQs Jan 30 Written By As a leader, the ability to navigate difficult conversations is crucial. Whether it’s delivering constructive feedback, resolving conflicts, addressing performance issues, or discussing sensitive topics, these conversati... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.513 | 0.836 | ["leadership", "crisis", "communication", "networking", "war_conflict"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758046 | [
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e can lead to stronger relationships, enhanced team morale, and improved overall performance. In this article, we’ll explore essential skills for mastering difficult conversations and offer practical tips for leaders to improve their communication and foster a culture of trust and respect. 1. Skill: Active Listening On... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.639 | 0.848 | ["leadership", "crisis", "communication", "management", "ethics"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758133 | [
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stand the perspectives and concerns of others before responding. Why It Matters Active listening helps you fully grasp the other person’s point of view, which is key to finding solutions and building rapport. It also makes the other person feel heard, valued, and respected, which can diffuse tension and promote constru... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.443 | 0.854 | ["education"] | 481 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758226 | [
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reflect back on what the other person is saying. Ask open-ended questions to encourage the other person to share more. Avoid interrupting, and instead, let them finish before responding. 2. Skill: Emotional Regulation Difficult conversations often evoke strong emotions. Whether it’s frustration, anger, or defensiveness... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.591 | 0.85 | ["crisis"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758318 | [
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lm, composed, and focused, even when the conversation becomes heated. This helps you maintain control over the dialogue and create a safe environment for others to express their emotions constructively. How to Master It Practice mindfulness techniques, like deep breathing or pausing before responding. Be aware of your ... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.422 | 0.836 | ["war_conflict"] | 449 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758443 | [
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se of the conversation, not on personal feelings. Take a break if needed, especially if emotions are running too high. 3. Skill: Empathy and Compassion Empathy is the ability to understand and share the feelings of others, while compassion is the willingness to take action based on that understanding. Both are key when... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.38 | 0.864 | ["management", "crisis"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758607 | [
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can lead to better problem-solving and resolution. When people feel that you genuinely care about their perspective and well-being, they’re more likely to engage openly and collaborate toward a solution. How to Master It Acknowledge the other person’s feelings without judgment. Use phrases like “I can understand how yo... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.362 | 0.85 | ["decision_making", "war_conflict", "economy", "education"] | 499 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758690 | [
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jumping to conclusions about their intentions. 4. Skill: Clarity and Transparency In difficult conversations, ambiguity can lead to misunderstandings and escalate tension. Leaders must communicate with clarity and transparency to ensure that their messages are understood and that expectations are clear. Why It Matters ... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.461 | 0.834 | ["communication", "leadership", "crisis"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758759 | [
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so fosters trust, which is essential for maintaining positive relationships in the workplace. How to Master It Be direct but respectful when expressing your message. Provide concrete examples and explain the reasoning behind your decisions. Avoid jargon or overly complex language—keep your message simple and straightfo... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.467 | 0.852 | ["war_conflict", "communication", "decision_making", "crisis", "networking"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758828 | [
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and addressing it effectively is an essential skill for leaders. Knowing how to manage and resolve conflicts during difficult conversations is crucial to maintaining harmony and productivity. Why It Matters Unresolved conflict can negatively impact team morale, collaboration, and performance. By addressing conflict dir... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.489 | 0.82 | ["communication", "war_conflict", "leadership", "management", "ethics"] | 439 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758903 | [
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yone and create a more positive work environment. How to Master It Stay neutral and avoid taking sides—focus on resolving the issue, not winning the argument. Identify the underlying issues causing the conflict and explore solutions together. Encourage open dialogue between the parties involved, ensuring each person fe... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.581 | 0.826 | ["negotiation", "war_conflict", "economy", "rhetoric"] | 415 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.758955 | [
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romise or solution that everyone can agree on. 6. Skill: Giving Constructive Feedback Giving feedback, especially negative feedback, is one of the most challenging aspects of leadership. However, it’s essential for growth and development within a team. Why It Matters Constructive feedback, when delivered properly, can ... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.394 | 0.838 | ["leadership", "management", "philosophy"] | 491 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.759014 | [
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s growth and fosters a culture of accountability. How to Master It Focus on specific behaviors or actions, not personal attributes. Use the “SBI” (Situation-Behavior-Impact) model to structure your feedback: describe the situation, the observed behavior, and its impact. Be solution-oriented—offer actionable suggestions... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.412 | 0.664 | [] | 433 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.759658 | [
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rcement to keep the conversation constructive. 7. Skill: Knowing When to Pause or End the Conversation Not every conversation will reach a resolution in one sitting, especially if emotions are running high. Knowing when to pause the conversation or schedule a follow-up is an important skill for leaders. Why It Matters ... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.613 | 0.834 | ["leadership"] | 420 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.759717 | [
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n time to process can prevent further escalation. Pausing or ending a conversation allows both parties to cool down, reflect, and return to the conversation with a clearer perspective. How to Master It Be aware of signs that the conversation is becoming too emotional or unproductive. Suggest taking a short break or rec... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.606 | 0.852 | ["war_conflict"] | 466 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.759765 | [
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will continue and that their concerns are valid. Set clear next steps for the follow-up discussion. Conclusion Mastering difficult conversations is a critical leadership skill that can transform your approach to team management and improve your overall effectiveness as a leader. By honing your skills in active listenin... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.656 | 0.846 | ["leadership", "management", "crisis", "war_conflict", "philosophy"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.759829 | [
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l be better equipped to handle challenging situations with confidence and poise. Effective communication is at the heart of strong leadership, and with these essential skills, you can foster better relationships, resolve conflicts, and guide your team toward success even in the most difficult of times. Previous Previou... | https://www.joshhmiller.com/blog/mastering-difficult-conversations-essential-skills-for-effective-leadership | Mastering Difficult Conversations: Essential Skills for Effective ... | joshhmiller.com | unknown | false | 0.61 | 0.838 | ["leadership", "war_conflict", "communication", "strategy", "management"] | 464 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:45.759925 | [
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J Gen Intern Med . 2019 Feb 19;34(5):744–749. doi: 10.1007/s11606-019-04874-2 Feedback Redefined: Principles and Practice Subha Ramani Subha Ramani , MBBS, PhD, FAMEE 1 Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA Find articles by Subha Ramani 1, ✉ , Karen D Könings Ka... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.514 | 0.856 | ["education", "career"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000057 | [
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dicine and Life Sciences, Maastricht University, Maastricht, Netherlands Find articles by Karen D Könings 2 , Shiphra Ginsburg Shiphra Ginsburg , MD, PhD, FRCPC 3 Department of Medicine and Wilson Centre for Research in Education, Faculty of Medicine, and Mount Sinai Hospital, University of Toronto, Toronto, Canada Fin... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.506 | 0.712 | ["education", "career"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000211 | [
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and the School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands Find articles by Cees PM van der Vleuten 2 Author information Article notes Copyright and License information 1 Department of Medicine, Brigham and Women’s Hospital and Harvard M... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.503 | 0.696 | ["education", "career", "philosophy"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000286 | [
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Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands 3 Department of Medicine and Wilson Centre for Research in Education, Faculty of Medicine, and Mount Sinai Hospital, University of Toronto, Toronto, Canada ✉ Corresponding author. Issue date 2019 May. © Society of General Internal Medici... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.371 | 0.852 | ["education"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000369 | [
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tion is fed back to modify and improve future action. In medical education, newer conceptualizations of feedback place the learner at the center of the feedback loop and emphasize learner engagement in the entire process. But, learners reject feedback if they doubt its credibility or it conflicts with their self-assess... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.401 | 0.83 | ["communication", "war_conflict", "education", "philosophy", "rhetoric"] | 463 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000462 | [
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, acceptance, and incorporation into performance. Understanding and application of specific aspects of psychosocial theories could help in designing initiatives that enhance the effect of feedback on learning and growth. In the end, the quality and impact of feedback should be measured by its influence on recipient beh... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.437 | 0.828 | ["communication", "career", "resume", "education", "philosophy"] | 427 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000564 | [
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care and not the skills of the feedback provider. Our objective is to compare and contrast older and newer definitions of feedback, explore existing feedback models, and highlight principles of relevant psychosocial theories applicable to feedback initiatives. Finally, we aim to apply principles from patient safety ini... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.438 | 0.84 | ["communication", "education"] | 482 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000694 | [
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readily acknowledged and addressed as strengths. KEY WORDS: feedback, residency education, feedback culture, sociocultural theory, feedback credibility The term “feedback” has its origin in mechanical environments and refers to an auto-regulatory mechanism where the effect of an action is fed back to modify future acti... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.372 | 0.844 | ["education", "communication", "philosophy"] | 496 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000782 | [
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to as positive or negative feedback respectively. The term is now used in various professions in the context of performance appraisal and practice improvement. Once dominated by expert opinions and recommendations, 1 , 2 feedback in medical education has shifted its attention to feedback provider-recipient relationship... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.572 | 0.85 | ["communication", "networking", "career", "education", "philosophy"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000867 | [
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dback, explore feedback practices and models used in medical education, and review tenets of relevant psychosocial theories applicable to the design of impact-enhancing feedback initiatives. FEEDBACK: A VITAL COG IN THE WHEEL OF COMPETENCY-BASED MEDICAL EDUCATION In the era of competency-based medical education, format... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.444 | 0.836 | ["philosophy", "education"] | 500 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.000955 | [
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p between their current and expected performance. 6 – 10 In several studies, medical students and residents report that faculty feedback is infrequently provided and vague language has little impact on their performance. 4 , 11 – 13 Clinical teachers report several barriers including lack of time and space for direct o... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.392 | 0.834 | ["philosophy", "networking"] | 451 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001049 | [
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dback would damage teacher-learner relationships. 14 – 17 Tackling complex barriers related to interpersonal relationships or institutional culture demands understanding of these factors. 18 – 20 TRADITIONAL DEFINITIONS AND MODELS Older definitions of feedback emphasize teachers’ skills in providing feedback, a mostly ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.395 | 0.836 | ["networking", "philosophy", "education"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001190 | [
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ers’ performance in a given activity that is intended to guide their future performance in the same activity.” 1 The “feedback sandwich” model, which recommends starting and ending with positive feedback, interposed by negative feedback, 21 has not been shown to improve learner performance. 22 The Pendleton model featu... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.41 | 0.83 | ["negotiation", "philosophy"] | 481 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001256 | [
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deficiencies, and teacher agreement/disagreement. 23 However, most older definitions and models have not adequately showcased learner engagement in the conversation or their role in creating a road map for performance improvement. It had been assumed that improving teachers’ feedback skills would somehow lead learners ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.408 | 0.854 | ["negotiation", "philosophy", "education"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001331 | [
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n are unidirectional with the direction of flow from teachers to learners. Learners’ performance improvement is assumed, and learning opportunities are not consistently created to allow for or document behavior change. Recent research suggests that teachers’ perceptions of effective feedback may not be shared by learne... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.397 | 0.854 | ["education", "war_conflict", "philosophy"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001414 | [
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he first-line providers of patient care and it is important to preserve their self-esteem and autonomy during feedback conversations. Such settings warrant a learner-focused model with learners as active seekers of feedback and contributors to the conversation rather than passive recipients. 4 , 28 Short working relati... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.409 | 0.83 | ["networking", "war_conflict"] | 458 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001487 | [
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roaches may be needed to promote behavior change. Therefore, the landscape of feedback needs to shift from teachers’ feedback techniques to learners’ goals, acceptance, and assimilation of feedback, regardless of the duration of working and learning relationships. To do this effectively, key factors that influence feed... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.366 | 0.846 | ["networking", "education"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001549 | [
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n recipients; until learners act on feedback, the feedback loop remains incomplete. 3 , 8 , 9 , 29 , 30 However, learners reject constructive feedback, namely feedback on deficiencies or areas for improvement, if the process or provider lack credibility in their eyes. 16 , 31 – 33 Credibility is influenced by factors s... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.482 | 0.856 | ["networking", "philosophy"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001620 | [
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ongruence of data with self-assessment, and perceived threat to self-esteem or autonomy. 17 , 27 , 30 , 34 – 37 Two recent feedback models, the R2C2 model (relationships, reaction, content, and coaching) and the educational alliance model, place learners at the center of a feedback conversation and prioritize learner-t... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.562 | 0.828 | ["networking", "diplomacy", "education"] | 433 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001699 | [
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t target change in learner behavior and practice. 38 – 42 Institutions need to promote trusting teacher-trainee relationships within a safe learning environment and facilitate regular direct observation of performance to enable meaningful feedback exchanges. 4 , 19 The feedback encounter is a complex exchange of inform... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.406 | 0.838 | ["education", "philosophy", "networking"] | 487 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001763 | [
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interpersonal tensions, and the learning culture. 15 , 16 , 18 Although clinical supervisors are aware that feedback is intended to improve trainee performance, many struggle to provide constructive feedback as they do not wish to be seen as unkind, and wish to preserve self-esteem of and their relationship with traine... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.399 | 0.848 | ["networking", "war_conflict", "education", "philosophy"] | 474 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001832 | [
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ts: the recipient, the provider, and the context. Figure 2 is a depiction of a central role for learners’ performance improvement in the feedback loop, influenced by factors related to feedback providers, recipients, and the institutional context. Figure 2. Open in a new tab Sociocultural influences of feedback can be ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.566 | 0.826 | ["philosophy"] | 442 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.001925 | [
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s), and feedback culture related (institutional). Learner-centered models of feedback emphasize the central position of learners in the feedback conversation with performance improvement as the end goal. Feedback Recipients Feedback models which cast learners as passive recipients are likely to be ineffective in gradua... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.444 | 0.814 | ["education", "philosophy"] | 415 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002008 | [
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o actively engage in appraisal of their practice. 43 Feedback acceptance is influenced by feedback-seeking behaviors, ability to self-assess, and perceptions of threat to self-esteem. 30 , 44 , 45 Goal-orientation of learners may also have a strong impact on feedback-seeking and acceptance. 4 , 43 , 46 , 47 Individuals... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.561 | 0.86 | ["philosophy"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002091 | [
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k perceived as negative or threatening to their self-esteem. 19 , 37 Those with a learning goal-orientation focus on mastery of tasks and professional growth. 48 , 49 Institutions and teachers can promote a learning goal-orientation by emphasizing mastery of new knowledge and skills rather than appearance of excellence... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.429 | 0.83 | ["education", "career", "philosophy"] | 461 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002179 | [
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eedback is necessary for performance improvement. Feedback Providers Medical education has historically focused on teachers’ skills in “providing” feedback to learners. 1 , 2 , 50 , 51 Its impact on learner behavior will likely be enhanced if feedback initiatives enhance teachers’ skills in promoting a positive learnin... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.445 | 0.826 | ["education", "philosophy"] | 447 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002246 | [
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ack and action plans for performance improvement. 30 , 34 , 52 It is essential that clinical teachers observe segments of their learners’ performance in a variety of domains, debrief observations in a timely manner, and provide opportunities for learners to implement action plans. Finally, it is important for teachers ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.448 | 0.83 | ["philosophy"] | 430 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002316 | [
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s both strengths and areas that need improvement. Feedback Culture A strong feedback culture promotes ongoing formal and informal feedback targeting continuous performance improvement. 53 , 54 Educational institutions can establish such a culture by facilitating trusting relationships between teachers and learners, bui... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.596 | 0.84 | ["philosophy", "networking", "education"] | 496 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002392 | [
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arners about the process and content of feedback. 16 , 19 , 55 – 57 More research is needed to explore how institutional culture can influence the quality and impact of feedback, feedback-seeking, acceptance, and performance improvement. 5 , 39 , 41 , 42 Understanding sociocultural factors in various learning and work ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.444 | 0.846 | ["career", "education", "philosophy"] | 487 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002448 | [
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on behavior change and professional development. THEORETICAL PRINCIPLES RELEVANT TO ENHANCING THE IMPACT OF FEEDBACK Since recent research has described feedback as a complex interpersonal encounter with relationships playing an important role in learner acceptance and behavior change, 4 , 12 , 18 it would be useful to... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.455 | 0.86 | ["networking", "career"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002502 | [
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levant to the sociocultural aspects of feedback: (1) sociocultural theory, 58 (2) politeness theory, 59 and (3) self-determination theory (Table 1 ). 60 The theories highlight core principles that can guide development of new models and enhance techniques for effective feedback conversations, especially in clinical set... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.605 | 0.834 | ["management", "motivation", "networking", "education", "philosophy"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002562 | [
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r continuous performance improvement and are described in more detail below. Table 1. Three Relevant Psychosocial Theories, Core Principles that Could Enhance the Impact of Feedback, and Corresponding Strategies to Address Those Principles Relevant psychosocial theory Core principles Implications for feedback strategie... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.6 | 0.828 | ["philosophy", "communication", "education"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002617 | [
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liefs and assumptions Educators: - Identify learner abilities using a developmental approach - Calibrate gaps in learners’ current versus expected performance - Provide formative feedback to guide independent practice - Use coaching skills for learner growth Institutions: - Provide a safe and just team culture - Establ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.559 | 0.686 | ["management", "philosophy", "networking", "social_justice"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002674 | [
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heory Self-efficacy/self-image Autonomy/freedom from imposition by others Educators: - Initiate feedback conversations with previous examples of excellence - Obtain learner goals and engage in goal-directed feedback - Facilitate learner reflections to calibrate gap between current performance and expected performance -... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.562 | 0.68 | ["philosophy", "networking", "career", "social_justice", "education"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002736 | [
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s: - Facilitate teacher-learner relationships - Encourage direct observation of performance - Train teachers to provide constructive feedback based on observed behaviors - Orient learners to seek feedback and train them to accept feedback and incorporate into performance - Establish an environment of gradual, increasin... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.564 | 0.688 | ["philosophy", "motivation", "networking", "education"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002793 | [
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Intrinsic motivation Educators: - Shift the focus from the individual to the context - Shift from instructional messages to self-regulation - Shift the focus from the perspective of feedback providers to recipients - Direct observation of performance - Encourage self-reflection and self-assessment - Challenge learners ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.559 | 0.694 | ["philosophy", "motivation", "crisis", "education"] | 511 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002881 | [
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ntinuous improvement mindset - Stimulate learning goal-orientation - Emphasize excellence and safety in patient care Open in a new tab Sociocultural theory, which proposes that humans learn largely through social interactions influenced by cultural beliefs and attitudes, grew from the work of Vygotksy. 61 Drawing upon ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.39 | 0.822 | ["education", "philosophy"] | 434 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.002983 | [
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through participation in communities of practice. 58 As learners assume increasing responsibility for their activities, they move from the periphery to the center of a community. Since clinical learning occurs through team interactions and collaboration, institutions should attend to the broader community in which lear... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.38 | 0.844 | ["education", "communication", "management", "economy", "rhetoric"] | 512 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.003058 | [
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d to (a) identify learner abilities using a developmental approach, (b) calibrate gaps in learners’ current versus expected performance, and (c) provide formative feedback to guide independent practice. Concepts from Brown and Levinson’s politeness theory are relevant to feedback conversations. This theory, from the fi... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.584 | 0.828 | ["philosophy"] | 448 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.003117 | [
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egative, play a role in most social interactions. 59 , 62 The positive face reflects an individual’s need to be appreciated by others, and the negative face reflects an individual’s need for freedom of action. The clinical environment is characterized by interpersonal relationships between teachers and learners, and mu... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.382 | 0.842 | ["management", "networking", "social_justice"] | 466 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.003252 | [
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hus a breach of the norms of expected politeness. Honest constructive feedback is essential for longitudinal growth as self-affirmation alone is not the path to professional improvement. However, clinical teachers tend to emphasize positive performance during feedback exchanges to avoid damaging teacher-learner relatio... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.461 | 0.84 | ["networking", "career", "war_conflict", "education", "philosophy"] | 500 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.003861 | [
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rsations, an area that warrants further research. 63 Self-determination theory, described by Ryan and Deci, states that human beings tend to regulate behaviors autonomously, take on challenges, and learn through intrinsic rather than extrinsic motivation. 60 Extrinsic motivation is driven by external factors with the g... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.526 | 0.834 | ["motivation", "crisis", "agents", "war_conflict"] | 477 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.003923 | [
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tisfaction rather than to achieve a given result. 60 We propose that intrinsic motivation would positively influence feedback-seeking, acceptance, and assimilation, therefore performance improvement. Ten Cate et al. suggest approaches to boost intrinsic motivation during feedback conversations: shifting the focus from ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.423 | 0.828 | ["motivation", "philosophy"] | 488 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.003979 | [
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perspective of feedback providers to recipients. 64 WHERE DO WE GO FROM HERE? Based on evolving acknowledgement that feedback is a learner-centered and sociocultural phenomenon, it is important to swing the pendulum of feedback research and faculty development from teacher techniques to learner outcomes. Medical educat... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.43 | 0.834 | ["education"] | 487 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.004040 | [
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heir own institutions from multiple perspectives. Observational studies are necessary to examine teacher and learner behaviors during feedback conversations and explore whether intentions of speakers match the perceptions of receivers. Co-construction of feedback conversations, action plans for improvement, and new lea... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.456 | 0.808 | ["career", "education"] | 414 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.004152 | [
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are more likely to result in professional growth. 39 , 42 Finally, the most credible feedback on clinical performance might be from patients to fulfill the ultimate goal of high-quality and safe patient care. Integration of patient feedback into performance assessment is fraught with challenges, but if implemented effe... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.6 | 0.844 | ["philosophy", "crisis", "career"] | 471 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.004218 | [
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5 More research is needed in this important area. Applying principles from patient safety initiatives, we propose that educational institutions adopt a fair and just culture within which feedback is exchanged. Such an organizational culture ensures learning and continuous improvement through acknowledgement of areas of... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.567 | 0.828 | ["education"] | 445 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.004269 | [
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on humanism and accountability to excellent care. 66 – 68 Institutions have a major role in establishing this culture to mitigate the effects of the hierarchical clinical environment, empower learners to take ownership of their professional growth, and enable collaborative bidirectional feedback. This empowerment can b... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.575 | 0.84 | ["career", "economy", "philosophy"] | 505 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.004320 | [
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sionals have strengths and areas for improvement. Focus on reflective practice, lifelong learning, and continuous improvement is essential for safe and high-quality patient care. Relationships, not recipes, are more likely to promote feedback that has an impact on learner performance and ultimately patient care. 69 Aft... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.467 | 0.836 | ["communication", "decision_making", "networking", "education", "philosophy"] | 503 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.004387 | [
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rner self-reflection, and shared decision-making? Compliance with Ethical Standards Conflict of Interest The authors declare that they do not have a conflict of interest. Footnotes Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Ref... | https://pmc.ncbi.nlm.nih.gov/articles/PMC6502935/ | Feedback Redefined: Principles and Practice - PMC - NIH | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.518 | 0.692 | ["war_conflict", "decision_making", "ethics", "education", "philosophy"] | 509 | Performance Management Difficult Conversations | topic | 2026-04-10T16:04:46.004439 | [
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