By: Dr. Aaron Stump

We know quality feedback is critical for the professional development of dental teams. The question is: how should leaders efficiently give quality feedback to maximize its impact? Traditionally, performance reviews were the standard way of providing feedback and instruction. However, the performance review is an outdated model. The new method is what I call a Goal Setting Session (GSS).

I developed the GSS because the traditional performance review was not working due to poor motivation, little accountability, and lack of proper follow-up. I understood the motivation for lasting change is best achieved in a positive, supportive environment where individuals are empowered and self-motivated to make change rather than being forced or coerced. The performance review setting does not provide this. It centers on past performance, not on positive change for the future. I was also having a hard time keeping my team accountable because there was little documentation on what was discussed or what specific steps were needed to make positive changes. Furthermore, there was poor follow-up because reviews were done once per year. That is simply too long to go between evaluations. Just think, students have four report cards during the school year. Dentists should be doing the same with their “students.” All this considered, I needed to be a better coach for my team and using the performance review as a tool was not helping achieve my goal.

The most important factor in creating a successful and sustainable practice is developing a healthy culture. The GSS is one of many pieces in cultivating and nurturing healthy culture. A supportive and safe environment where trust is built and one can be vulnerable are key cornerstones in building a healthy culture.

It is essential as a leader you take on the responsibility of helping individual team members reach their goals. Why? Because the success and growth of the office depend on it. The theory of growth is simple: growth is reciprocal. If a team member is growing, then so will the practice. If everyone in an office is hitting their goals, then the office as a collective will grow exponentially.

The GSS method is based on motivational interviewing. This process is defined as a collaborative, goal-oriented style of communication and particular attention to the language of change. It is designed to strengthen the personal motivation of commitment to a specific goal by exploring the person’s own reason for change. Motivational interviewing is designed to empower people to change by drawing out their meaning, importance, and capacity for change.

The objective of the GSS is to promote positive change and growth by providing a safe place for the team member to self-direct and self-motivate using their own words. The GSS is essentially trying to invoke positive change by encouraging the team member to “speak their goal into existence.” Accountability and success are more readily achieved if one verbalizes their goals and holds themselves accountable. What sets the GSS apart from the performance review is the words of change are coming from the team member and not the person conducting the review.

The four components of conducting a productive GSS are 1) Scheduling; 2) Leading/Guiding; 3) Documentation; and 4) Follow-up.

Scheduling
The first step is to block time in all parties involved schedules so there is adequate time for the GSS. This includes setting time for the current session as well as the next one. I find that 40 minutes is sufficient for each GSS.

Leading/Guiding
Leading/Guiding requires active listening skills and asking questions to help guide the team member to verbalize their goal.

Documentation
Documentation requires three things. One, clearly state the goal. Two, establish a specific action plan. Three, set a realistic timeframe for completion. Documentation needs to be provided to the team member, so they also have a reference. This step aids in solidifying success and accountability because their leader has heard and transcribed their words on a living document that will be reviewed in a few months.

Follow-up
Follow-up should be done in three to four months. Change is best achieved in small increments while consistently reinforcing feedback. Positive change is like fluoride: low concentration and high frequency for maximum benefit. The follow-up process is simple: review the goals and see if they were achieved. If so, it’s time to celebrate! Let them know how their positive change has contributed to the overall success of the practice. If not, ask them why they did not achieve their goal and encourage them to try again.

The secret to conducting a productive GSS is encouraging proper goal setting using the motivational interviewing process. This takes time and practice. It may be three sessions before a person really gets the hang of it. Be patient. To maximize success, the team member should be encouraged to verbalize only 2-3 goals. Goals need to be specific, realistic and attainable. For example, “be a rockstar chair-side assistant” is not an effective goal. A more specific goal would be, “be thoroughly prepared for each restorative appointment so I don’t have to go looking for dental supplies or instruments in the middle of an appointment.” Prompting verbal commitment to change is essential. This can be done by asking open-ended questions such as, “Why is this important to you? Are you committed to achieving this? How do you plan on doing this? What obstacles do you anticipate and how will you overcome them?” In event of a standstill, the person conducting the GSS should interject and ask permission to comment, “I think I have some insights. Do you mind if I share them with you so we can discuss them?” Remember, the essence of the motivational interviewing process is to have the individual verbalize their acknowledgment of the need and desire for change and not to directly tell them what to do. It is more important for them to verbalize it than it is for the leader to assign it.

Remember we cannot expect the team to take the practice to the next level if they are not provided with the resources to make positive changes. One way to further help the team member personably verbalize, hence solidify their commitment to change, is to ask: “What can I do to help you?” This takes the pressure off the leader to find the solution and helps cultivate a more collaborative environment. Furthermore, a deeper trust is created when the leader delivers on their promise to help in ways the team member asked and not how they deemed appropriate. This lets them know they were heard and they are valued. The leader is there to help them succeed and attain their goals as a team.

Being able to create a healthy work culture is a great blessing and opportunity. We are in a unique position to positively impact many people in our lives and communities. The GSS will allow you to more effectively produce positive change and growth from yourself and the team. This enhanced performance from the team as a collective will culminate in massive overall success of the practice. Ultimately, you and the team will consistently provide high-quality dental experiences and continually be taking the office to the next level.

Resources:
Coyle, D. (2017) The Culture Code. Bantam Books.
Miller, W.R. & Rollnick, S. (2013) Motivational Interviewing: Helping people to change (3rd Edition). Guilford Press.
Ramsey, D. (2011) Entreleadership. Simon and Schuster.
Sinek, S. (2014) Leaders Eat Last. Penguin Random House.

Dr. Aaron Stump is the owner of Charlottesville Pediatric Dentistry in Charlottesville, VA. He has been a practice owner for eight years and has “ridden the wave” of private practice ownership. Creating a positive team dynamic and healthy team culture is a passion of his.