Critical appraisals – simply indispensable!

Wherever people collaborate closely, as they usually do in hospitals, conflicts may arise. Everyone has their own experiences, their own style. Solutions are needed, if possible before conflicts become a strain on the working atmosphere. We have compiled tips for you on how to conduct targeted appraisals.

Nobody really likes criticism – neither the criticised nor the person who has to give the negative feedback. As a result, in many cases conflicts are not actively addressed, tackled and ideally resolved. However, this is the worst option, because unresolved conflicts tie up energy, and the mind is not free for important performance in the hospital. Especially in the medical environment, good cooperation for the purposes of patient care is essential. Therefore, for leaders it is important to take the proverbial bull by the horns and face up to the responsibility.

It pays to criticise

The positive news: Well-conducted critical appraisals are an opportunity! A candid discussion can provide the space for exchange of views, initiate development of new proposals, and generate new perspectives. Problems arise only when conflicts are not dealt with constructively and thus escalate.

But how do you communicate problems in an appreciative way when emotions are running high? As a matter of principle, no discussion should ever take place spontaneously in passing. What is important here, as it is for most things in life, is good planning. Do not react emotionally from the situation, but take the time to prepare a conflict talk.


Good timing is needed

If there is a specific reason, it will be expedient to schedule a personal interview within one to two days at the most. This gives you time to sort out your thoughts, but the incident is still fresh enough in your minds and the memories are unadulterated. At the same time, anger and disappointment cannot accumulate permanently.

It is also helpful to have a neutral place to talk, and an undisturbed atmosphere. Sometimes a change of scenery such as a meeting in a café or a walk outside is also suitable. It needs to be clarified who should participate in the discussion. Is it going to be a one-on-one discussion, or are selected stakeholders additionally to be brought in? It is recommended to keep the group as small as possible, and to inform the employee about the topic of the meeting beforehand. Announce briefly “it’s going to be about incident XY, the situation in the operating theatre, or…”. This also gives the other person the chance to prepare for the discussion.

As much clarity as possible

It is important to analyse the central content of the criticism in advance. Precisely which topic do I want to address – what do I want to clarify? This is about the factual level. At the same time, however, it is also crucial to know your own emotional attitude towards the person being criticised, and to clarify the relationship level for yourself in advance. The aim is to enter the clarification discussion in a friendly, open and constructive manner on your part. Check whether you can bring this mindset with you, or optimise it if necessary.

It is helpful to have defined minimum and maximum goals for yourself beforehand. It is not a matter of merely denouncing misconduct and poor leadership . Instead, the focus should be on improving cooperation and/or processes in an objective and constructive way. An agenda with goals formulated clearly as key words helps to keep the discussion on track. Otherwise there is a great danger of getting carried away by emotions or bogged down in details. In the best case, criticism should be understood by the counterpart as appreciative assistance and a chance to learn from mistakes and to develop further.


Dos and don’ts

Both parties to a critical appraisal should treat each other respectfully and politely. The discussion should always remain fact-oriented and not descend to the personal level. Listen, let them finish, speak your own mind, and remain authentic. Avoid at all costs harping on mistakes or even raising the voice to give more expression to what is being said. This applies to both sides, of course. And please note: Your body language is never silent. Posture, facial expressions and gestures make up a very large part of our communication.

Specific tips for an appreciative discussion:

  • Send “I”-messages
  • Focus on facts
  • Avoid accusations and “you”-messages
  • Avoid words like “never” and “always” as much as possible
  • Beware of generalisations
  • Focus on things and not on the person
  • Steer quickly from the problem to the solution approach

To ensure that the criticism has been understood, the person being criticised should have sufficient time for questions. Allow and even encourage the participants to describe their own opinion or accounts of incidents. The discussion is successful if eventually a solution can be jointly elaborated.



Criticism needs to be learned and requires practice, just like any good medical work does. With a structured approach, respect and appreciation, the effort will pay off. Because in every dispute there is the chance of a new approach to a solution. A professional and constructive critique is always worthwhile – for both sides.

As an aid for a clearly structured appraisal, we have compiled the following for you to download.


Go to download

Document 7 phases of the critical appraisal – with examples and helpful formulations.






Die 7 Techniken der Konfliktlösung

Shaw, Gerard
Communication Excellence, 2020


Kritikgespräche führen

Hölzl, Franz; Raslan, Nadja
Haufe Verlag, 2017


How to talk to anybody

Borthwick, Derek
Independently published, 2022


The hard thing about hard things

Horowitz, Ben
Harper Business, 2014


L’entretien de face à face

Mucchielli, Robert
Esf, 2020


Influencer avec intégrité

Laborde, Génie
Intereditions, 2021


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