Take a look at this picture. What might the archer be thinking about the person in their sights? They’re probably seeing them as being a problem they have to deal with. But it’s pretty obvious to everyone – or at least everyone apart from the archer – that both parties face impending disaster here.
You’d like to think that someone would bring this to their attention. Someone should say something. But who? Does it take a matter of life and death before we speak up? Would we speak up even then? Or would we assume someone else will?
We’ll come back to reconsider this image from a couple of different perspectives shortly. But first, let’s look at some data.
Doctors and feedback
Almost 1,000 doctors have completed a questionnaire which we’ve included as an optional activity in our Medical Leadership & Management Online Course. Here are a couple of charts which illustrate the results we’ve collated in relation to the subject of feedback. It’s important to note that these results are the self-assessment of the participants, rather than the judgement of anyone else.
So, 50% of the doctors who have taken part state that they don’t challenge or give corrective feedback either enough or at all. It’s worth pointing out that the respondents cover a broad spectrum from Foundation Years to Consultants, surgeons, physicians and locums.
And the next chart illustrates that they see this being repeated all around them in their colleagues’ behaviour.
Although there are many reasons why we might hold back from saying what needs to be said in different circumstances, our participating doctors are telling us they believe they should be speaking up more effectively.
So what about archer syndrome?
Now, let’s return to our picture. There may well have been times when you’ve felt like the person in the archer’s sights. You may have had some bad experiences with receiving feedback or challenge where the other person didn’t seem to care about the consequences. Their message was an arrow fired in your direction which caused you pain and possibly lasting damage.
But now consider this. When you see something that isn’t right, do you hold back from speaking up because you worry that it could all go wrong? Do you worry that there will be problematic consequences?
Maybe you worry that the other person will be upset. They might react angrily toward you. Or worse, could someone perceive you to be a bully? Could speaking up result in someone making a complaint about you? Or could you be embarrassed, labelled as an interfering know-it-all or even ostracised? In other words, do you hold back because your don’t want to be like the archer? Do you worry that challenging someone’s actions or behaviour would trigger a disastrous chain of events?
You definitely want to avoid suffering from archer syndrome where you take aim and fire without considering the consequences. Many doctors on our courses confide in us that this is why they avoid giving feedback. They’re afraid it will end badly. But what are the consequences of not speaking up when something needs to be said?
We need a cultural shift
Feedback skills are essential for many areas of modern practice. We explore the subject in our various teamwork, leadership, teaching and mentoring courses. We need a significant cultural shift in the approach to feedback. And not just anonymous, annual, written feedback – which has it’s place – but actually speaking to other people in everyday situations. We need a culture where doctors know what they are doing well, what they are doing which could be problematic and how to improve. This requires freeing doctors from fear of archer syndrome and empowering them to speak up in a constructive manner.
Playing an active part in this cultural shift will in itself requires you to and bring the problem to the attention of others. You’ll need a high standard of feedback skills. It’s never too early, or too late, to work on this area.
Ideally, when giving feedback, our aim has to be to help the other person. We must choose the correct time and place, then send our “arrow” as a constructive message for them to safely receive.
What are you doing to play your part in achieving this cultural shift?
Stephen McGuire – Managing Director
