1. Lal, M. Maureen MSN, RN


Feedback is a necessary and important part of career growth, and feedback from peers is shown to improve everything from job performance to quality outcomes. So why is feedback so hard to give and receive? This month's Magnet(R) Perspectives examines the role of feedback in the workplace; why peer feedback programs are gaining traction, especially in nursing; and how your organization can benefit from a formal, systematic peer feedback process. The column also explores how the Magnet environment promotes peer feedback and offers tips to help you create a successful program that fosters openness and communication.


Article Content

Feedback is an essential part of learning. In the workplace, regular feedback can build trust, motivate employees, and reduce turnover. Peer feedback in particular is especially effective. Research shows that it provides opportunities to advance skill development, promote quality improvement, improve results, and support a culture of safety.1 Peers experience the same work conditions and challenges, which enhances their ability to give honest feedback.

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Successful peer feedback evaluates an individual's performance against specific organizational standards, goals, and objectives. It rounds out feedback from supervisors to provide a fuller picture of personal and professional strengths, as well as opportunities for improvement.2 In the healthcare environment, peer feedback is necessary to improve standards of care and ensure that nurses are competent and practice within boundaries of professionally accepted norms. Garner3 found that formal peer review has gained acceptance as a method to improve nursing quality and safety. It can validate and advance nursing practice and promote the highest level of care for patients.


The Magnet(R) Connection

Peer feedback is a longstanding tenant of ANCC's Magnet Recognition Program(R). It is an essential element to ensure that nurses deliver safe, ethical, and evidence-based care.


The 2019 Magnet Application Manual defines peer feedback as "An objective process of giving and receiving deliberate input to identify areas of strength and opportunities for improvement for a nurse peer."4 Peers are described as "nurses with similar roles and education, clinical expertise, and levels of licensure."4


Peer feedback is part of the Exemplary Professional Practice component of the Magnet Model. In Magnet organizations, nurses at all levels engage in periodic formal performance reviews that include a self-appraisal and peer feedback process for assurance of competence and continuous professional development. To attain Magnet recognition, an organization must have systematic peer-review practices in place. Source of Evidence EP11 requires organizations to show the use of these practices for nurse executives, nurse managers, and clinical nurses.


Creating a Culture of Acceptance

Peer feedback is not intended to be an anxiety-producing exercise, but rather an opportunity for personal growth. It is a necessary factor for each one of us to meet our goals and fulfill our potential. Think about the term "360[degrees] feedback." The whole idea is to increase self-awareness and help us see our blind spots.


Still, experts agree that giving and receiving feedback do not come easily. In their book Thanks for the Feedback, authors Douglas Stone and Sheila Heen5 report that when they ask people to list their most difficult conversations, feedback always comes up. This applies to givers and receivers alike. "When we give feedback, we notice that the receiver isn't good at receiving it. And when we receive feedback, we notice that the giver isn't good at giving it," they write.5


So how can you cultivate an environment in which feedback is welcomed and encouraged? The Harvard Business Review's6Guide to Delivering Effective Feedback states that the better you can express yourself, the greater the opportunity to encourage positive change and growth. Likewise, LeClair-Smith et al1 found that nonpunitive peer feedback programs that incorporate evidence-based nursing practice, quality, and safety standards and are specifically targeted to improve patient outcomes were most effective.


Guidelines from the American Nurses Association recommend that peer feedback be practice-focused, timely, and conducted in the framework of a learning organization.7 A continuous learning culture that fosters a common commitment to achieving and sustaining desired quality outcomes will promote openness and acceptance of the feedback process and help your nurses feel safe.




1. LeClair-Smith C, Branum B, Bryant L, et al. Peer-to-peer feedback: a novel approach to nursing quality, collaboration, and peer review. J Nurs Adm. 2016;46(6):321-328. [Context Link]


2. Lai CY. Training nursing students' communication skills with online video peer assessment. Comput Educ. 2016;97:21-30. [Context Link]


3. Garner JK. Implementation of a nursing peer-review program in the hospital setting. Clin Nurse Spec. 2015;29(5):271-275. [Context Link]


4. 2019 Magnet(R) Application Manual. Silver Spring, MD: American Nurses Credentialing Center. [Context Link]


5. Stone D, Heen S. Thanks for the Feedback. The Science and Art of Receiving Feedback Well. New York, NY: Penguin Random House; 2015. [Context Link]


6. HBR Guide to Delivering Effective Feedback. Brighton, MA: Harvard Business Review Press; 2016. [Context Link]


7. American Nurses Association. Peer Review Guidelines. Silver Spring, MD; 1988. [Context Link]