Managing Criticism

Receiving criticism from our colleagues can be one of the most difficult aspects of practising medicine. It threatens confidence, can lead to feelings of shame and regret, and can disrupt doctor-patient and doctor-doctor relationships. In many cases, however, the criticism may be well-intentioned and designed to optimise patient care, and so all doctors should strive to manage personal criticism effectively. When delivered by effective communicators, negative feedback can be a very useful educational opportunity.

Avoid ‘Knee-Jerk’ Responses

It is often tempting to try and offer an immediate defence when receiving criticism. This can be represented by anger, denial and rejection or by making comments that you later regret. Try to avoid making an immediate defence and take time consider the criticism that has been made.

 

If, on reflection, you feel the criticism may be justified and / or well-intentioned:

Ask for Honesty and Comprehensive Details

It is important to remember that doctors may also find it difficult to give criticism, but may feel obliged to do so in order to protect patients. Accordingly they may feel reticent and may only offer brief details of their concern. Invite them to give as much detail as possible and be in full possession of the facts before considering a response. Effective learning is only likely if the feedback is comprehensive, intelligible and trusted.

Turn the Discussion into a Learning Opportunity

Establish how you could do things differently in future. Set learning objectives to help you achieve the necessary changes to your practice. Revisit the situation with your clinical supervisor once you feel you have learnt from the criticism and take the opportunity to demonstrate that you are able to manage negative feedback in a mature and useful fashion.

Thank Your Critic

Thanking the person that criticises you may be instinctively difficult, but will show them that you are serious about self-improvement and optimising patient care, rather than becoming defensive and rejecting their well-intentioned advice.

Reflective Writing

Self-reflection is now a requirement of most training programmes and is stated as one of the GMC’s Duties of a Doctor. This usually takes the form of written reflective pieces submitted to online portfolios. Ensure that you follow the Academy of Medical Royal College’s guidance on entering information into ePortfolios.¹

 

If, on reflection, you feel the criticism is unjustified and / or ill-intentioned:

Discuss with a Trusted Colleague

A neutral third party may offer a different view of the criticism, and may disagree that it was unjustified and / or ill-intentioned. They could suggest ways in which the advice could be used productively. If they agree that the criticism is unfair or has been inappropriately delivered (i.e. in a way designed to undermine or intimidate) then consider a discussion with a senior colleague such as an educational or clinical supervisor, and refer to RCSEd advice.

References

1. AoMRC. Guidance for entering information onto ePortfolios (2016). Last accessed 7th January 2018 at http://www.aomrc.org.uk/publications/reports-guidance/academy-guidance-e-portfolios/

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