Feedback… It’s Food (for Thought)


Grab a hot drink, put on your beanie and scarf, and come for a metaphorical walk with me so we can chat about feedback.

If you’re worried that I'm going to tell you that feedback is important, then you’re right to be worried, because it is important; but also: don’t worry. I know we’re beyond such banal concepts as “it’s important to get feedback” and “cold things are cold”. Instead I want to explore the idea of what feedback you should be rejecting.


Because… I have noticed that some people speak about feedback as if it were sacred. As if the cursory remarks scrawled by workshop participants require us to question our fundamental principles. As if comments like “I don’t like role-plays” and “Can we finish at 4pm as I have a train to catch?” were brilliant insights into a cosmic truth. And this infuriates me because feedback is too important to be followed blindly.

Feedback is important.

Important things demand scrutiny.

You are what you eat

Feedback is just like food: what you put into yourself affects what you become. If you simply swallow whatever feedback you’re offered, without checking to see if it’s a sensible thing to eat, then you can end up poisoning yourself on toxic remarks, or becoming addicted to a diet of sweet, sugary flattery.

Comparing good feedback to good food is useful because we already have such a clear approach to eating well (whether we follow it or not). Let’s explore the similarities.

You need food to live / you need feedback to grow

In some medical careers, feedback is rapid and unambiguous, while in others, feedback is both cryptic and delayed.  A study comparing the performance of doctors in these two career pathways showed that the first group tended to get better and better with time, while the performance of the second group of doctors peaked early in their careers, then gradually tapered.

If you care at all about what you do, you want to be in that first group. Two main things drive improvement: pushing yourself out of your comfort zone (ie do stuff which is hard but not impossible); and getting useful feedback from someone who understands what you’re doing.

Not everything is food / not everything is feedback

Look around you. Lots of things are not edible. Similarly, a lot of the comments that come your way are not feedback… but to a person starved for food, even inedible things begin to look appetizing. In the absence of real feedback, we start to read meaning into random events, which is exhausting.

The awesomeness of healthy food / The brilliance of high quality feedback

Lots has been written about how to make feedback high quality: how to give it, how to receive it, frameworks such as the “positive critique” or the “sandwich” model, the necessity of making feedback SMART, FIT and ABLE, and so forth.

My quick check before I take in a piece of feedback is that it has to be constructive (good) and insightful (wise)*, in other words “does this person have my best interest at heart?" and "does this person know what they’re talking about?”

Unfortunately, there are a few people who simply enjoy dispensing advice in order to feel important, and there are even some people who like to deliver cruel jibes in the guise of feedback. **

* I realise that this is the “Glinda the Good Witch of the North” model, but even she made some pretty sarcastic remarks.

** If you have lived only amongst kindness and charity and it seems unbelievable that anyone would deliver nasty feedback, you can find examples of eye-openingly unhelpful behaviour in the comments section of any website, usually starting from about the fifth comment down. Google “rainbow cake comment apocalypse” to see this in action.

You need a variety of food / you need different types of feedback

Here are some of the types of feedback you should be receiving:

Short and long-term positive affirmation feedback (you’re doing the right thing right now / you’re doing the right thing with your life) are useful so you can keep doing whatever it is you’re doing.
Perspective from an outside observer, and the insights that you couldn't have come up with by yourself, are building blocks for growth.
You need a little bit of praise now and again – it’s very motivating (just don’t let it make you complacent).
Unpleasant truths and criticisms are very useful, as long as they are both good and wise.

(It would be stretching an analogy to say that these are your carbs, proteins, fats and vitamins, so I won’t.)

A healthy diet for the mind

Feedback shapes what we do, and what we become. The process of building a healthy feedback diet involves seeking out regular, varied and high quality feedback, and rejecting the dross. This doesn't mean you can happily absorb the positive feedback and ignore the negative – far from it! – but it does mean you should ignore the careless, caustic or uninformed remarks.

An analogy is just a tool that lets us re-examine something in a new light, hopefully this analogy gives you some ideas for your intake of feedback.

You may think of other ways that good feedback is like a healthy diet, but I'm also interested in how the analogy fails to hold up. It’s something to muse on, and of course… your thoughts help me refine my thoughts.



Take a breath. Let’s start again (again)


When I first started practising medicine, I worked for about six months before I had annual leave. My break lasted two weeks. At the end of it, I was certain that I had forgotten everything I knew about being a doctor.

This feeling turned out not to be true, but it did turn out to be common – I've had friends call me the night before returning to work after a long absence, and declare that they had forgotten how the heart works, or something equally ridiculous*. It’s a bit like impostor syndrome (the feeling that you’re faking being a smart person, but no-one has caught on yet) which is also really common.

* I believe this was said to me by a cardiologist.


This post is about resetting when you feel out of your depth, or you can no longer do a thing that you used to be able to do.

One of “those” days

Every now and again, when you perform a complex task, one where the outcome will depend to some extent on your mood and your ability to think on your feet, you’ll have an off day. It may be because your favourite café was closed, or someone you admire brushed you off, or you simply woke up filled with the unshakeable sensation that all humankind’s achievements are meaningless. For whatever reason, you’re not performing with your usual agility. This definitely happens when improvising, and the temptation is to try and be brilliant – to show the audience that despite the mediocre work you've dished up so far, you are capable of genius. It seldom works.

Here is an effective strategy:

Recognize when you aren’t on fire. This takes insight.

Let your team-mates make the main decisions and be in the forefront.This relies on having trust in your team.

Stop trying to wring brilliance out of your tired brain, and go back to basics. This means that you have to have a strong grasp of the fundamentals.

I want to talk mostly about item 3, the fundamentals. You should be able to articulate the core elements of your role. Maybe in one word, or a brief and unforgettable list of instructions, or a trigger phrase that gets you into the zone.

Trigger phrases

Once when I was performing in an improv show in Texas, the director asked me to name something I found difficult. “Speaking in a believable South African accent,” says I. The director then challenged me to attempt this during the show, resulting in a performance which was probably interesting to watch, but only in the way that it'd be interesting to watch a caveman try to reroute your modem, setting fire to the drapes in the process.

The experience spurred me to work on my South African accent. One of the tricks with accents is to have a “stock phrase” which you say out loud to reset your brain. The phrase will contain a spread of sounds which are unique to that accent. For me, my South African accent reset phrase is “All she wanted was to look at the photographs.”  If you ever hear me mutter that to myself, be prepared to be transported to Cape Town.

When your issue is more about self-belief, you have to get back in touch with why you’re doing this complex thing in the first place – your values. You also have to separate your self-belief from other people's beliefs about you. I recommend a ritual created by game designer Jesse Schell.

Let’s say it’s about writing. You say to yourself:
    I am a writer.
    I am a writer.
    I am a writer.


Improv has quite a few fundamentals, for example “make your partner look good” or “be changed”.

Medicine has a core sequence as well: gather information, work out the problem, take action, check on the outcome. In medical language: history, examination, investigations, diagnosis, management, follow-up.

In both cases, we practice, practice, practice those core things until we can do them in our sleep, with confidence.

If anyone ever asks you why you’re making the whole class of advanced masters practice basic moves, it’s because one day your confidence will be shaken, or you’ll be running from killer bees, but you will still be able to do the thing you are good at.

The hidden wondrousness

There’s a further reason why all this is great. If you know that you know how to start again from the beginning, and you know that when you do, it will all come back to you quickly and easily – you won’t be afraid to fail.

And when you’re not afraid to fail, your world gets much bigger.

Leaders… Do Teams Even Need Them?


The chocolateness of Easter has come and gone. Well done, those of you who did not eat Easter eggs. Also well done, those of you who recognized that small indulgences are good for the soul, and ate the Easter eggs.

This month, I was asked: does every team need a leader?


Conventional wisdom says, “Sure, you need a leader. A team without a leader is a team that gets nothing done.” Conventional wisdom then gazes off wisely into the distance, puts one foot up to lean on a fence and concedes, “Some teams manage to just scrape by without a leader… but every team does better with a leader in place.”

I can’t help questioning the validity of these “always” type statements. Are there times when you don’t need a leader? What functions does a leader provide?

The functions of a leader

A leader provides direction. The leader has a vision for what she wants the group to achieve.

A leader sets the standard. The leader cares. She wants the outcome to be excellent, and she has the interpersonal skills to motivate the rest of the team to meet her standards. The leader’s behaviour influences the team’s culture, morale, motivation.

A leader takes responsibility. Ultimately, the success or failure of the team will rest on the shoulders of the leader. When a decision is required, the leader makes the final call.

A leader is acknowledged by the group. The group has accepted that this person is the leader, either because they've been voted in, assigned by a higher authority (or maybe they are the higher authority), or they have the most passion and skill.*

* In some groups, the leader is the person who is most reliable at answering emails.

Good leaders have a whole list of other attributes, like excellent communication or empowerment of others, but let’s leave that alone for the moment – right now I'm talking about the functions of leadership.

My suspicion is that a cohesive group with a shared vision can get along quite well without a leader. My darker suspicion is that the term “leader” often brings to mind the traditional hierarchical (and usually patriarchal) model. And I've had enough of patriarchy.

Thankfully, there has been a shift away from the old, authoritative style of leadership to a more consultative approach. Instead of dictating terms, today good leaders are inspiring and persuading. They even share leadership roles across a team, each person rising to the occasion as their skills are required, or a problem arises which they find particularly intriguing.

Accidental leadership

It’s easy to slide into the role of leader without intending to, maybe because you've got a background in management or accounting or some other necessary skill; or you’re one of those people who can’t do a job unless you do it properly. You begin to notice that people are looking to you to tell them what to do. A few people are lazily sitting around – you're doing all the work, so they've become passengers. Some of the passengers start fighting with each other for better seats. How do you get off this train?

Luckily, people tend to listen to a leader, and you can use that fact (whether you enjoy it or not) to your advantage. It might be at the AGM, or a team gathering, or via a group email. My suggestion is to talk to the team in a way that returns the functions of leadership to them.

Inspire everyone with the shared vision. If you’re on the team, you probably know what it is. It’s very powerful to have it stated.

Remind people that there is an expectation that everyone contributes. The train doesn't run itself.
This segues neatly into the statement of responsibility. We all have a job to do.

As you are relinquishing leadership, you should acknowledge who the team now answers to. It might be management, or the patients, or the parents, or the clients, or the shareholders… but the team members also answer to each other. People are motivated to do well by other people who they can actually see and speak to.

Be careful not to be too inspiring with your words, or people will just remember “the day that Maire gave that stirring speech and we all realised that she was the leader we needed.”

What you want to achieve is a shared model of leadership, where everyone has the same understanding of the team’s purpose, team members support each other, and people have autonomy over how they achieve the team’s goals.

I leave you with the stunning finding of Project Aristotle. In 2012, Google began researching 180 of their teams, to look for patterns that would point them to the key quality of the most effective teams. The findings were complex, but in a nutshell:

Good teams are ones where the members are nice to each other.

More on that later.