The Cultural Seeds of a Learning Culture

Let’s face it – most of us suck at giving AND receiving feedback. No one wants to hear they haven’t done well and certainly hate to upset others. I know what a time-waster overthinking difficult conversations can be.

About 8 years ago, I did a training for ICU at the Royal Darwin Hospital. I taught the feedback sandwich and never before had I conducted a training that I never felt good about sharing. It felt incongruent, and there was a part of us all in that training that knew it wasn’t the way to go. I could just sense it. I thought back then it was the feedback (sh#t sandwich) that was the icky part.

What I didn’t realise was that giving and receiving feedback emerges from a mindset about learning and how trust works in relationships. It arises from the seeds planted in everyday interactions and within the leader’s perspective about themselves and others. Giving and receiving feedback can be the most transformational elements at work. Done well, it improves how confident a person feels in their future and changes how they see themselves, extending past the changes the behaviour makes in their practice.

Leaders generally avoid giving feedback as it is stressful for both parties. When attempted, it wrecks relationships, bruises egos, and ruins confidence.

To become accredited as a healthcare leadership coach, I had to interview 12 nurse leaders. It was unanimous: avoiding supplying feedback was the number one leadership issue. Feedback is, at its core, a conversation about helping another person improve. Research from Dr David Rock, who bases his work on neuroscience, says workplaces usually grade themselves a C or D on the feedback report card. We aren’t doing well or not at all, increasing the stress already around us and reducing patient safety, nurse competence, and performance.

I’ve ditched the feedback sandwich in the bin and use a different process that is clearer, give the receiver more autonomy and agency, and actually improves the relationships.

To help a junior team become clinically confident quicker and improve patient safety, you need a process that leaders are optimistic about and is easy to implement. Here is the model I use to tackle this issue with leadership teams.

Many have found this model handy to conceptualise learning and broaden the learning from having educators in each ward/unit/department and doing continuous education in double staffing time.

If you are open to having your junior workforce becoming clinically confident quicker for greater patient safety and less stress on the team, make an appointment here Book Michelle Taylor (

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