Welcome, good afternoon, everyone. You're at the Florida Society of Pathologists, Grand Rounds. I am Dr. Marilyn Bui, the president of FSP, and we are having this very special session entitled Evaluation and the Feedback for Faculty and the Trainees. We have two distinguished faculty members. One is Dr. Nicole Riddle from University of South Florida. The other one is Dr. Mercy Giordano from University of Miami. As you can see, our schedule is Dr. Riddle will kick off on evaluation and feedback from Associate Residency Program Director's perspective. Dr. Giordano will give us a talk on chair evaluation and the feedback of faculty. And then in the last 15 minutes, we're gonna have a panel discussion joined by Dr. Aziza Nassar, the chair of Mayo Clinic in Jacksonville, and Dr. Anwar Siddiqui, the Residency Program Director from University of South Florida to join as a panel discussion and Q&A. With that said, let's move on to the very first talk by Dr. Nicole Riddle. Dr. Riddle serves as the Associate Director of Pathology Residency Program, and her expertise is in bone and soft tissue pathology, neuropathology, dermatopathology, and the general anatomic pathology. She is a senior pathologist for Ruffalo-Hooper and Associates, and she practiced at Tampa General Hospital. She also has a joint appointment as the Associate Professor of University of South Florida. And Dr. Riddle has been honored with several awards, including the ASCP 2018 40 Under 40 Top Five, and also listed on the Pathologist Magazine as a Power List. And the most recent award was the CFU Resident Advocacy Award. With that said, let's welcome Dr. Riddle who gave us a presentation. Thank you. My unmute button decided to move on me. Hello, thank you, everybody. Thank you very much for having me. Thank you, Dr. Bowie, for that lovely introduction. I'm assuming y'all could hear me or else somebody would probably say something. Without further ado, I will start. So today I'm going to give a talk about a little bit about giving and receiving feedback more from like a residency program director's perspective. So focusing more on trainees or people that have trainees. I do need to thank Dr. Sarah Bean and Sarah Zhang. Originally this was a talk that I had given with them. And so I've now morphed it some and then of course shortened it some here. And it's also a talk that I would gladly give to anybody if they ever wanted a virtual presentation of the longer lecture. What we're going to cover today is why feedback is important and then some little tips on how to provide effective feedback and then how to effectively receive feedback. So the importance of feedback, one of the original papers was back in 1983 by Dr. Endy. He said, without feedback, mistakes go uncorrected, good performance is not reinforced and clinical competence is achieved empirically or not at all. And that basically in a very succinct sentence explains why it's important for us to have these talks and to train on how to give and receive feedback. So first things to cover feedback versus evaluation and how they're different. They're of course similar and related, but they are different. Evaluation is, it's summative. It's what you do like at the end of a rotation or at the end of a quarter or even the yearly evaluations that we do throughout life. It judges your performance, has a final assessment. It's much more formal. It's often much more high stakes depending on the situation. And it does ensure that standards are attained. Where feedback is meant to be formative, it's meant to be helpful. It's meant to be given along the way. So it should be very timely. It should be relatively quick after said occurrence. It should be descriptive. It should not be judgmental. It should very much just be like this was adequate, this was not, and then this is how it should be done better. And it can be a lot more informal and just basically shows opportunities for improvement so that people can get better along the way. Then do we really need feedback? And I love this little meme. I think that's funny. I'm sure all of us have met people that didn't necessarily seem to view themselves the way that others viewed them, whether they saw themselves being better than they were or saw themselves maybe not being as good as they were. Those people are out there. But it's definitely important to get feedback because you just don't know how you see or how you're seen through other people's eyes. And sort of in order to be the best positions and people we can be, it's good to kind of know how we're coming across. What are the barriers to feedback? This is kind of where giving feedback can be very difficult and there can be a lot of barriers. Time is the major one, especially if you're in academics, you typically have a very busy schedule. The trainees are busy, the faculty are busy. So just trying to take the time to do it. And also the time is important because you have to find the right time. You don't wanna be like passing somebody in the hallway and be like, oh, by the way, that case that you wrote up was done really poorly. Yeah, thanks and then keep walking. That would not be helpful. That would not be the right time. Fear of an emotional reaction. Most of us do not like giving constructive criticism, constructive feedback. We certainly don't wanna hurt people's feelings, but at the same time, we need to remember that people are learning. We're all always learning, but in particular, if you have learners or medical students or residents, it's our job to kind of point those things out, but it's still difficult. And we know that some people might react more emotionally than others. And so we certainly don't envy having to put ourselves in that uncomfortable situation. There's also some expectations. Are they expecting to get feedback? Do they know it's coming? Does the faculty know they should be giving feedback? Have you specifically told them they should be doing that routinely? We also, again, there's usually uncertainty of usefulness. You wanna give feedback, but is it actually gonna do anything? Is it actually gonna change anything or are they gonna get better? Do they know what to do with it? Lack of training. Clearly talks like this are not very common. So most of us don't know how to properly give feedback and or what to do with the feedback we get. If it's an isolated incidence, maybe you don't need to give feedback right then if it's only a one-time thing. Certainly own lack of confidence. If you don't have confidence in yourself and your ability, then you're gonna be less likely to give it. I like this, that the learner or staff is likable. People do not feel comfortable giving difficult information or difficult feedback to somebody that they like. It does make it harder. I usually use that as an excuse to say like, I don't wanna have to say this to you. Everybody likes you. We wanna know, but it's still my job to point these things out. And then of course the hierarchy. It can be either awkward. If you're quote in a hierarchical, I never like to say above or whatever, but there is a hierarchy above somebody. But then sometimes you need to give feedback to somebody at your level, which can be hard. And or if you're trying to feedback up, which is a whole nother conversation, but that certainly comes into play as well. So some components of effective feedback, thinking about all of those barriers or to find the sweet spot between environment, receiver and giver. You wanna make sure it's the right location. Like I said, not in a busy elevator, not in the middle of the resident lecture where everybody's in there, that sort of situation. Make sure you do it in a quiet place where you have the proper time to give the feedback and then make sure that you're in the right state of mind. You know, you're in a bad mood that day and you've had a bad day. Maybe that is not the best time to be giving feedback to a resident that is not at all related to why you're having a bad day. And then making sure the receiver is in the right place. Maybe making sure they know you're about to give them feedback. Sometimes even say, hey, I'm giving you feedback now, let's talk a little bit. And of course, you know, if they just lost a pet or if they were up all night sick with their child, maybe also not the best time to add to their stress, maybe consider doing that at a different time when they are more in the right mental state to be able to actively receive the information. Some of the guidelines, you know, remind people that you have common goals. I always tell my trainees, like it is my job to point something out, like everybody has something to work on. There is nobody who is immune from somehow getting better. So I always tell them, it is my job when I meet with you to point these things out. Like I point something out to everybody and that kind of makes them feel better because it's like, you know, and my goal is just to make you the best you can be. Again, you need to make sure it's timely and expected and don't just like grab them in the hall. Try to set aside time either at the end of the day, it doesn't have to be long, just a few minutes, like two, three minutes, it could be done adequately in that time, depending on how difficult the conversation has to be. But make sure you set aside time to do that or at the end of the week, if you're with somebody for the week, et cetera. You need to focus on the behaviors, not the individual, you know, how accurate your diagnosis was, how adequate your FNA procedure was, you know, how clean the smear was, those sorts of things. You wanna focus on the actual behaviors. If the behavior is their professional behavior, you wanna say, when you said X, that is not the right way that should have been said, or maybe you don't realize the tone you have comes across this way, but that you need to very much focus on the specifics. And then of course, things that people can change. You don't, you know, if somebody happens to speak with a certain intonation that there's just no way they would be able to ever change because that's just part of them, you know, then that is not something that you should give feedback on as long as they can communicate clearly. And then there's a litmus test. They talk about, is it descriptive? Is it constructive and nonjudgmental? If the feedback you wanna give covers those three things, then that means it's probably good feedback. Should include positive behaviors. You know, not just all the constructive negative things. You wanna reinforce the positive things. That's how you make them stick. And of course the quantity is regulated because you don't just constantly wanna be criticizing somebody all day, every day. Then that also just kind of ends up shutting it down and being too much for them to have. So feedback methods. There are multiple different methods that I wasn't gonna go over all in here. And I thought this little comment was cute. One method that I didn't have a slide for, but I do want to mention is like the one minute preceptor is what we often do a lot, like around the scope or if you're doing CP, when you're looking at SPEPs or flows, is basically like you ask the trainee a question, you get them to settle on a response and then you either, you know, reinforce the correct answer or adjust it, you know, to give them what the correct answer should have been in a kind way. And that's kind of a quick way to do that. But then I did wanna make sure that I covered the feedback sandwich. I'm sure you're all aware of, you know, the sandwich where you say something good and then you say something bad and then you say something good again. That is no more, no longer recommended. So many people, they expect it, that they hear the good, that they're waiting for the bad, so they don't hear the good. And then after you give them the bad, they can't hear the last good again. And so it doesn't end up working as well. Also, some people think that you're making up the good just in order to make the sandwich. So there's now a new sandwich called Ask, Tell, Ask, where you're supposed to ask the trainee, hey, how do you think that went? How did you think you did on sign out today? How did you think that FNA went and see what they have to say? Sometimes or many times you'll find that they themselves recognize that they should have been better, they could have been quicker, or they didn't get as many diagnoses right as they would have wanted. And then it's more of a conversation. And then you tell them kind of how you saw it. So you might either say, yes, that's exactly what I saw and then talk about it. Or you might go, well, they didn't quite see it quite right. You know, you'd be like, oh, well, this is kind of how I interpreted it or what I noticed. And then you ask them again, well, how do you think we can address this? Or how do you think we can fix this? And kind of have them come up with their own plan of what they could do better next time. The benefits are that as it's learner centered, you're focused on them, asking them to take part in the conversation and it incorporates their perspective. It does helpfully avoid assumptions and judgments, especially if you presumed they were thinking a certain way. If they tell you they were thinking a different way, then that can be very helpful. And then it does promote lifelong reflection. That's something that all of us should do throughout our careers. And so if we start them doing it now, hopefully they will continue. Some guidelines to receiving feedback. Because, you know, just think of feedback as being a gift. Feedback, whether it's good or bad or given well or given poorly, it is something that you can do something with to try to improve yourself. It has to do with whether you have the growth mindset or a fixed mindset, which is kind of two different ways of thinking and being. Some of these are ingrained. Some people are naturally more one or the other with the I am always trying to change and grow sort of situation. And some people are naturally more fixed, but you can train yourself to try to be of a more growth mindset. And in general, that is usually better for improving. And it's actually been shown to be associated with lower stress, lower rates of depression. People with fixed mindsets tend to be less plastic in their abilities. And so it ends up stressing them out more. So there is some more science behind that. When you're getting feedback, you wanna listen closely. If you have personal feelings that are involved, whether it's feelings you've had related to this person giving you feedback in the past or whatever, try to parse that out. Very much just try to get the actual specific information. Remember that it's not meant to be a judgment. Hopefully they mean it because they do wanna improve you. Most people are not gonna have a difficult conversation if they don't have your improvement in their best interest. And then if you need to seek clarification or specific examples, if you're not quite sure what they're talking about, and then take time to process it, take time to think about it, think like feel about it, think about it, seeing what sort of information you may or may not. And I always say, maybe it wasn't the right information, maybe they misunderstood, but at the same time, it's always good to have that. And then one last thing I wanted to cover is they've actually done a lot of studies recently. They did it in neurosurgery, they did it in emergency medicine and residency programs where they split their residents. And after giving them feedback, they had one group that they specifically told to go and make SMART goals related to that feedback, and another group that did not. And SMART goals are what it says here, they're specific, measurable, attainable, relevant and time-bound. If you have not heard those yet, you will hear them a lot. They're very big in a lot of organizations nowadays. But if you very much set a specific measurable goal and what time you wanna do it by, they found that they were extremely much more likely to actually manage those goals and then did better subjectively and objectively as well. So just quick summary, we do all give and receive feedback daily. Feedback should be timely, specific and nonjudgmental. Do include positive feedback. Know your own triggers when you're receiving feedback and try to remember that it can be a gift, it's meant to improve you and do the best you can on it. And then if you're getting feedback, especially if you're in more of a training standpoint, establishing SMART goals can help you succeed in going forward. And with that, thank you. Wonderful, Dr. Little. Thank you for all those excellent insights on giving and receiving feedback. Now we're going to change gear and introducing Dr. Mercy Giordano talking about the chair evaluation. Dr. Giordano is the chair of department of pathology in the laboratory medicine at the University of Miami, chief of pathology at Jackson Health System and a CLIA laboratory director. She, in addition to be an excellent surgical pathologist with expertise in geopathology and the cytopathology, she's also a researcher and an educator. So today we're interested in her approach to giving evaluation to faculty with the goal for fostering faculty's professional growth. Welcome, Dr. Jorda. Thank you very much, Dr. Bui and MSP for inviting me to speak with Dr. Nicole Riddle and with this group of panelists. It's a real pleasure for me, thank you. So we're gonna start starting with the faculty evaluation. So what we would like to discuss today is why a chair should perform faculty and annual evaluation. And also we'll talk a little bit about how our different forms of perform faculty evaluations. So why we should do as chairs, faculty evaluations and why faculty should expect to be evaluated. And very nicely, Nicole already described the difference between feedback and evaluation. And here we're not gonna talk about just feedback. We're gonna talk about a very precise, documented evaluation that the main goal for that evaluation is to promote the faculty, right? To promote the faculty well-being and it's their development, not only professionally, but remember we spend many, many hours at work. So if you have a good work environment where your goals are well-set according to your motivators, that is gonna give you a feeling of a well-being, right? And that's extremely important. The chair should be totally involved on that, right? Because promotes the relationship between the faculty and the chair. Discusses appropriate mentoring, which is an important fact at the time of development for faculty, discuss progression. So time to, you can discuss the progression towards promotion, outcome measurement to check where are you in your outcomes. And also it's important at that time that you can't as chair and as faculty, you align with your chair in the department and institutional goals. Then let's talk about remote engagement and relationship between faculty and chair. It's an opportunity like no one. The one-on-one between the chair and the faculty needs to be an open talk. Not a booze, needs to be sincere. The chair needs to be sincere, wanting the best for the faculty. And it's the time that the chair appreciates, needs to appreciate that faculty contributions, accomplishments, and to provide again, feedback. Which Dr. Riddle has spoke to us. Sometimes not easy to provide, but it's important to provide this feedback. It's also very important for the chair and the faculty to have the relationship where the internal motivators of the faculty are more clear to the chair. Not everyone wants the same. Some of us want much more compensation. Everybody likes compensation, but for some that is key, for others is important, but other things are also important in their development and a feeling of well-being. So that is so, so dependent of each individual that to know each one as a family. Like I always describe that it's like, when you are a parent and you need to know all these different forms to be your kids, it's extremely important to know that for your faculty. Of course, it's not gonna be at the level of personalization, but yes, should be at the level of the professional side, right? We need to know our faculty and faculty needs to be open to be shown to their chair who they are. No problems, no taboos, transparency completely. And that always has been proven in literature that provides the best results in retention and feeling of well-being and belonging to a department. Also, it's a very good opportunity without any mediators, right, to promote distrust and review. That's important to review the compensation of the past year, right? As Nicole mentioned, normal evaluation, it's about a period that the past, normally is the prior year. And it's the compensation that the faculty had. And also it's important to see the productivity that these faculty have. And what's the gap between productivity and compensation? Important to have that evaluated. And also allocate what's gonna be your next year expected faculty time FTE, full-time employee distribution, how much is gonna be clinical, how much is gonna be education, research, if you have, et cetera. Now, let's go to discuss appropriate mentoring. Another very important thing is that the faculty should be having, or hopefully having a mentor, right? Especially, especially at the beginning when it starts in an apartment, a mentor should be crucial. One or more mentors, right? And to have in an apartment a mentoring committee and mentors associated to different faculty is extremely crucial. The mentor also can provide to the chair how his or her mentee is doing, what it's called individual development plans. And it would be very good that the chair has these plans with him or her at the time to do these annual evaluation. So everything it's a link together, right? It's a good link between the mentor, the chair and the faculty. And because we all need to be aligned. Now, outcomes measurement, important. The outcome measurement is important because it's a good moment on the time that you can present to the faculty how the faculty is doing. Again, productivity versus compensation. Here it will be the delta. In green is productivity, right? In orange is compensation. So you see there's a huge compensation here in that year, in FY 2018 however here, the compensation in FY23, it's the gap, it's a small, right? Nobody can tell us what should be this gap, but definitely needs to be some form of documentation in terms of outcomes. And it's important also at that time that we can present the clinical FTE, how much RBU, if that's what's follow, you should have for your clinical FTE, how much you did, et cetera. It's a good moment that you can evaluate the faculty for the clinical operations, the quality that they do, the education, how much they do and how they do the funded research, if they do have administration. And very important, it's very advisable to add citizenship and professionalism in the faculty evaluation. We all should be professional. We all should follow citizenship rules. And finally, we should have like a summary understandable of what it's gonna be that score for you, right? Clinical education, research and administration and provide kind of a metric number. And that would give you where you are sitting in comparison to the rest of the faculty. Now, the communication and alignment with the department and institutional goals is extremely good to be used in a moment of evaluation. So that time when you are one-on-one with the faculty should be used to understand the faculty, how the faculty feels actually following the ask-tell-ask rule or method that Nicole Riddle was mentioning. We ask the faculty to a self-evaluation, we'll talk in a second. We are asking, how are you feeling, right? And then we're gonna tell, well, look, according to certain metrics and certain policies, you think that you are doing very well here, but they think that perhaps you could do better than that or not, or you are doing an extraordinary job. And especially when you do with people that they cannot or they don't see themselves that they can do better. Actually, it's very important to ask them, that probably is not the way that you think. We can fix that together. I'll support you, we'll give you support, but we need to know your feedback. In occasions also we need to say, is that what you want, right? Is that what you are pursuing? And help the individual. And that's the most important thing. At the time of evaluation, the individual faculty is extremely important, but also as for the chair and the leadership of the department is a good moment where the chair determines very clearly or re-emphasize what the department needs, right? From the faculty in general, and even further than that, what the university is expecting from us as a department. And why we should do chairs, faculty evaluation, culture of transparency, right? Not that thing that, you know, I think you're good. Okay, I'll sign. No. Why there are differences in performance and that needs to be all measured and benchmarked. And it's extremely important for faculty development. We cannot let faculty go without understanding the boundaries and understanding where they are doing better than other areas because they need to help, right? The big role of the chair is to support and help develop in the faculty. And we all need different things, right? So it's extremely important that these feedback, it's mutual, right? It cannot be a barrier between the faculty and the chair. And that's extremely important. That's why we need to do faculty evaluations because that's gonna support faculty wellbeing, feeling of belonging, and definitely faculty retention. Now, methods to do that. There are many, right? I'm not gonna say that there is only one, but there are things in the methodology that are very general, right? An outline of time needs to be created. A plan for action-oriented face-to-face appraisals needs to be face-to-face. It should be one-on-one. And then also recognize that there are five steps. We'll talk about it. And device mechanisms to maintain and enhance performance. It's not just, we're gonna say, okay, you did that well here, not here, that, okay. Your score is two. But not to talk about what else we, the department, can do for you, right? That's extremely important to discuss that. That is the moment to talk about that. Now, outline. Really, the chair and the chair's leadership group, they should determine when to do it. Sometimes it's the institution who decides that, right? But when to do it and how to do it, who initiates the meeting, who attends the meeting, and how much amount of time. And, you know, very important, it's that everybody has the same amount of time and same type of methodology for fairness. Fairness, so the faculty members feel, it's not only a feeling, but they have the convincement that they are treated equally. And that's extremely, extremely important. Data points need to be there, right? Annual evaluation should not be, hello, how are you doing? I understand that you did well. You're happy, I'm happy, and so on. No, that's not a faculty evaluation. That's a hello, right? It's a hello, how are you doing, right? A faculty evaluation really is something that should be faculty self-assessment. You, as faculty, should be evaluating yourself. And that's why it's the ask that Dr. Riedel was mentioning. And then it's when the faculty or the chair, it's evaluating that ask in terms of, I'll tell you how I think you did. And then, you know, ask again, you know, how you think you can improve these areas here and how I, the department, and I can help you in creating that, right? It's important to have data for that and to have teaching evaluations, teaching portfolio, curriculum, peer evaluations, right? It's not a feeling, right? Evaluation, it's not a feeling. Should be medicated and it should be constancy that I am evaluating you, same as I'm evaluating the others, right? So this is extremely important. And it should be in a action-oriented face-to-face, right? The time of conversation should be very similar between all the evaluations, should be follow-up plans to your peer on an annual review, right? It's not like, okay, I'll see you in a year, right? Most of the time after you review the plans, you know, it normally it's a mid-year review and say, okay, we talked about that a few months ago. How are you doing? I'm supporting you enough. Do you do what you said you would do? If you don't, why you don't, why you don't do that is perhaps it's not exactly what you want. Let's rethink again, right? So it's, you know, mid-year feedback. And, you know, normally all the evaluations, they need to be, chairs like to sign off on the faculty members' self-evaluation with goals for the following year. And also like for goals of administration, goals for your education, goals for your research and goals for your clinical, according to your clinical FDA. It's a moment of transparency. There are five steps that we can recognize. They are set expectations. That's the first step. So one of the things that we must department do is to have a faculty annual evaluation policy where the expectations are there. Those policies, most of the time, are linked to expectations of the institution, right? So we create policies that they are linked with the institution expectations. After that, evidence needs to be collected from the faculty point of view, doing the self-evaluation, and also the department's point of view to collect evidence of evaluations for teaching, evaluations for any kind of activities, 360 evaluations, et cetera, that we have available, mentorship evaluations, et cetera. We then conduct the meeting. That should be, again, similar time, similar structure for fairness, and the meeting should be face-to-face and should be one-on-one. The chair also can decide if they want to add other faculty before the chair's evaluation meeting with the faculty. So they are one-on-one with, for example, the anatomic pathology director, and after that, it's gonna be the one-on-one with the chair having the anatomic pathology director evaluation, and hopefully also the mentor evaluation with the chair at the time to do the final one-on-one evaluation with the chair. So all that can be done, and it can be decided internally. The evaluation needs to be written, that's extremely important, and signed and submitted. So it's important, so that means constancy of what happens, and that's a period of time, normally it's a year, right? Now, talking about set expectations, normally, again, departmental policy, you need to talk about consult the guidelines, establish the timelines. Let's say we're gonna evaluate you for this year, and how many, you know, how many work reviews you're gonna need to do, how many days of coverage you need to do, et cetera, et cetera, and that is going to be important. Now, so to define, according to the institution, you know, why are we gonna evaluate? So a scholarship research, develop faculty development, teaching, clinical activities, service administrative, and leadership roles, and all that, these four should be giving some scores, and you say, okay, a score of one is outstanding, and a score of five is unsatisfactory, right? And how we do that, okay, so you have four points that you, four measurements that you wanna check, one is a scholarship and research, and that can be a lot of different items that they may have different points, there are many ways to do it, right, but that's one way, right, different points, and after, at the end, depending of your research, FTE distribution, so you should have so many points to have a one, so many points to have a two, et cetera, and at the end, you're gonna have a score for your scholarship and research. For faculty development, teaching, and mentoring is identical, right, needs to be scores, they need to be metrics that allows us to be fair and avoiding our bias, completely unconscious bias, bad bias. So the best way is to have a policy with all the metrics aligned. Clinical activity is the same, what is your work RBU target, right, according to the institution and metrics, did you do more than that, okay, good, how much more, okay, more than that is a one, more than that is a two, three, okay, you met the expectation, you didn't do very well, so you are a four, right, So all that should be aligned as well and identified. Same thing for administration and leadership roles and must be quantifiable, right? Because when we starting to do non-quantifiable measurement of measures, it's where our unconscious bias starts kicking. We need to collect the evidence, the data should be all presented. Normally it's through a website or through a software. And then it's the faculty has been prepared, prepare all the CVs and everything that's required. The chair also prepares and the office for evaluations, teaching, research service, what the faculty did, let's be ready, right? To evaluate this faculty and then it's the outcomes that it's annual review conversation, it's a conversation, individual development plan and also update on mentoring and support, resources support, right? It's to support and help the faculty to be developed. That is a checklist, I'm not gonna go over here but you have access to that presentation is just to have it in a more summarized way. And then you have the conduct the meeting, right? Prepare, communicate, please coach, set goals and then current self-reflection. Remember that the self-reflection is gonna be extremely important at the time of doing evaluation. The meeting should be very specific, I'm not gonna repeat myself, very specific and evaluating all the subjects that are gonna be part of the evaluation, research, education, clinical and service administration leadership. Remember, and Nicole already mentioned that, sometimes they are, some people are not gonna like what they're gonna hear because perhaps they think they did better than what they did, even though they have a faculty policy, right? That they could read and make sure and not to be surprised but that's how everyone is, you know, about the different growth of peaks mindsets that Dr. Riddle also mentioned. Even in general, we are often highly sensitive to perceive criticism and we should expect anyone that does an evaluation, some emotional reactions like I was not born to impress you. Relax, I'm not gonna do what you do but we as chairs and faculty, because that's a two, two time, right? It's a time that we need to understand that this is not punitive ever, that should be something to help the faculty. Finally, I'll tell you that sometimes when you have all the scores that this is the self-evaluated score and here is the chair or chief of score and they match, right? One, one, 1.75, 1.75. Okay, so it's perfect, right? Everybody's happy, we are all in agreement. However, in occasions, right? We do have scores that, you know, the faculty score as a three but the chief chair scores as much higher, 1.7. Oh my God, that's fantastic, right? The chair and the chief think that I'm doing better than what I thought. However, there are other group of individuals that they scored completely perfect as number one but we don't think that they were perfect. And then it's the question mark, right? Why? Why I did that? Why I didn't get a one, right? And first of all, I think it's important to respond to difficult reactions and we need to listen, right, as chair and the faculty needs to be very open and together engage in a conversation and try to avoid reactive feelings that they should not be constructive. So the chair has an important role to show and impact the faculty in that what you didn't make it at this point is because of that, that and that and I'll help you, the department is gonna help you to move forward in something potentially better. And cheer up, buddy, okay? Here's not a question of punitive reaction should be again, enhancing the faculty and a goal should scare a little not and excite a lot, right? We need to feel supported as faculty and we should be working together with our leadership of the department and institution to move forward. Finally, and I'm done, it's the evaluation should be written, not just verbal, should be signed and that's extremely important and should be sent and received by the faculty so they have it for their records and they can always follow up. Remember that we should always establish a follow-up schedule after the faculty annual evaluation and mid-year review is a very good thing to do and for new faculty feedback, not a faculty evaluation but the feedback like Dr. Riedel was mentioning, a scheduled feedback one-on-one every month or every quarter is extremely, extremely helpful to know more and help especially to break the barriers of the beginning of a recruitment. And with that, I thank you. I hope that faculty annual evaluations are gonna be enjoyable, positive and encouraging leading the meeting with a very positive energy. The last slide is just a very brief summary when you have the slides if you wanna use it and you have here the resources. Thank you. Thank you so much, Dr. Giordano. I know that you're the type of chair that really engage and empower the faculty, make them feel sense of belonging and support. I wish all our chairs have that kind of a draw to the faculty. So now we're gonna move to the next session and we're gonna invite two distinguished panelists. One is Dr. Ahmad Siddiqui who is a social professor and the director of pathology residency and pathology courtship at the University of Florida Jacksonville campus. The last but not the least, Dr. Aziza Nazar is the chair and a professor of the department of pathology and the laboratory medicine at Mayo Clinic in Jacksonville, Florida. So they are here to join this panel to answer some questions of focusing on feedback and evaluation. So feedback and evaluation is equally important for both the trainees, the residency fellows as well as the faculty. And Dr. Nazar is going to be the residency program director starting in July, 2024. So this is such a great opportunity that we're all sitting together discussing this topic. This just shows that in Florida, we have such a great talent and we have FSP as our professional home bring us all together, help each other. So the very first question I'm gonna ask Dr. Nazar is going to be what's the most important take home message did you get from this conversation? And then I will ask Dr. Siddiqui about that too. Dr. Nazar. Thank you so much for the presentation, phenomenal job. The most important thing, take the feedback as improvement, for improvement, self-improvement and to improve yourself but also for career and professional development. I would advise people, especially the junior staff and trainees, don't take things personal, take it as a key point. What are the things that I can improve myself in terms of improvement for my career but also for my educational purposes, for mentoring. I mean, there are so many resources available and we learn a lot. There are constructive criticisms that are always given to trainees as well as to faculty. Just take them at heart, but don't take them personal. That's my best advice to people. Very good. Dr. Siddiqui. Yes, so Dr. Riddle and Dr. Jodha did an excellent job clearly articulating all the important points and evaluation and feedback. And there's very little to add but I just want to reiterate some of the points from Dr. Riddle's presentation. Like she mentioned, it is feedback, is the process of giving learners information about their current performance so that they may improve in future. And think of it like you taste the soup while cooking and add a little salt for perfection. That would be more like a feedback as opposed to summative evaluation, which is more like at the end of their month long rotation, you give the formal feedback, you could give the feedback after every sign out pretty much. And it's very important to always label feedback because the resident or fellow comes back and tells you, okay, such and such is the diagnosis in this case. And you say, no, well, this is not the actual diagnosis. This is the diagnosis. And actually you're giving the feedback but they don't realize it. And they would write in their evaluation, I never got the feedback. So every time you say anything to the resident or fellow, you have to tell them, label it. This is your feedback, please. And this is your feedback. The diagnosis is such and such and it's because of such and such and such points. So you actually have to label it and tell them. And like again, Dr. Riddle said, ask, tell, ask, you can ask the learner self-assessing assessment, like what do you think went well with your presentation or whatever case they presented? And then you tell them your feedback and then ask the learner for feedback on your teaching or check for the understanding by the learner, whether they understood or not about the whole process. And also there are a couple of things that I think are very important. First of all, you can create a culture of feedback. Just tell them, oh, please remind me to give you feedback at the end. Let them know so that they are waiting for it. They will ask for it. And then limit your feedback to one or two things only. Don't throw the book at them. Otherwise it's not gonna be consequential. I mean, it won't be effective pretty much. And then it should be close to the event pretty much. And then the other important area is consider psychological safety, like put the trainee to ease. Use terms like we, me, I. For example, even I had problem learning this when I was at your stage. This would bring down your level to the level of the learner and they would open up. They would clear, I mean, ask questions freely. And also like if you give corrective, I mean, I'm sorry. If you give the positive feedback, you can give it in front of everybody. But if it's corrective feedback only privately to the person, it's gonna be detrimental. And also admit your own errors. When you admit your own errors, they feel very comfortable, the residents and fellows. Oh, I made the same mistake when I was at your stage. And that way they feel, okay, so I'm no different. I'm not bad. And they would open up and ask questions and stuff. So this is my take pretty much on what Dr. Riddle said. I think if we follow these things, I think it'll be good basically. Anything else you all want to add Dr. Riddle, Dr. Jorda, Dr. Nassar? Yeah, I just found this very nice model that talks about the SBI model, which is basically the best practice to give a constructive feedback. Basically recall the situation and then describe the behavior and the impact. I mean, just so you can have a very concrete constructive feedback. Don't talk about the individual, just you're trying to correct the behavior. That's one of the things that the ask, they'll ask or whatever the SBI model that's being promoted out there. We don't use the sandwich model anymore, which is basically a nice thing. And then the bad, and then, because you are basically filtering the information and diluting it, but you have to be sometimes direct. One of the things that there is a very good book out there about giving feedback, and it's written by one of these executive who work in Google and other places, but it's about radical candor. But you can be candid about or direct about your feedback, but also be personable. You're promoting your people. You're trying to be allies with them. You're not an enemy, so you have to be their ally. So this is, it's a very good book out there. It's called Radical Candor by Kim Scott. So this is a must. If you are somebody in a leadership role trying to give feedback for people, this is a very good book to have. I think another thing to those lines, Dr. Nadar, and is that we as people, we feel when the person who's in front of you sincerely want the best for you, right? So we need to be sincere, right? We wanna want the best for each one of our faculty, for each one of our residents. Some are gonna take as much more work than others. That's part of life. And we need to accept that, right? At the end, it may be that those who were very difficult at the beginning are gonna be extremely successful at the end, right? And we have multiple examples of that. But actually, I think the feeling of being sincere, right? It's extremely important. Evaluation, it's not just a trummet. A feedback, it's not a trummet. It's something that you want to give, and you as faculty would like to receive for the best of your faculty development, right? And when you're a resident, for the same, right? For your best of your education. And I think that to be honesty and being sincere goes a long way, right? We as chairs or as program directors, we may be wrong and we are wrong, right? We all are. So if there is this nice feedback between both entities, it's always better, right? Because I may be correcting myself and faculty, they see that the chair is correcting her or himself. This is good. It means that I may correct myself, right? So this kind of relationship, I think is extremely important to be sincere. They need to feel what's the best for them. It's such an important and powerful message. So this is one hour just passed by so quickly. We had such rich content, excellent presentations, and everybody's wisdom are all put together in this one hour. So on behalf of the FSP, I'd like to thank you, Dr. Giordano, Dr. Nicole Riddle, for your expertise and presentation. I'd like to thank Dr. Nizar, Dr. Siddiqui for your contribution to this. So the design is to leverage all the talents of Florida, helping each other at the same time, learning from each other. So I feel like we accomplished that goal. And at the same time, we like to thank the people who attended this lecture today. So that means you gave me the approval, showing that we are doing the right thing to design and moderate and organize this special lecture series. And also you're willing to spend your precious time participating and contributing. And the last but not the least, I'd like to thank our very own staff, Dr. Amber Naves, who is behind the scene, does a lot of organizational work. So let's put our hands together to give us a round of applause to all of you and Amber and everybody who attended. Again, this is a CME earning activity and also it's recorded. So thank you very much. Hopefully you're armed with this new knowledge. So you're going out to the world and you're gonna leave a very fulfilling and gratifying professional life. So thank you very much and best wishes. Thank you, Dr. Bui.

Florida Society of Pathologists

Grand Rounds

evaluation

feedback

faculty development

trainee improvement

self-assessment

professional growth

mentoring