Improvement vs. Fear Through Performance Reviews in healthcare essay

Improvement vs. Fear Through Performance Reviews

Factors that contribute to generating fear in employee performance reviews in a healthcare setting

Biased rating and poor feedbacks are factors that contribute to generating fear in employee performance reviews in a healthcare setting. Appraisal systems hardly lack bias. Managerial biases like dislikes and likes, disloyalty and loyalty as well as interpersonal relationships taint performance appraisals (Hess, 2012). For example, I once received negative performance reviews from my manager. My manager gave me low-performance ratings in several practice areas. The repetitive themes were that I had poor working relationships with others, I was rude to patients and staff and my desk was messy. Apart from the comment about the messy desk, the manager had never received any guidance concerning my work

Poor feedback occurs because managers are not comfortable communicating the outcomes of the evaluation which they feel are adverse to the affected staff. When managers withhold unfavorable evaluation outcomes from affected staff, they unconsciously create panic, fear, and anxiety among their staff (Hess, 2012). For example, when I asked the manager why there were only negative marks on my performance review, and what I could do to improve, he declined to talk about my questions concerning the evaluation. This left me feeling very nervous and wondering why the manager refused to discuss my questions. Improvement vs. Fear Through Performance Reviews in healthcare essay

Strategies to eliminate fear

Regular evaluation of employees is regularly evaluating employees is a strategy that can eliminate fear and to develop and implement constructive reviews that improve performance. Nikpeyma et al (2015) indicate that when nurses are evaluated monthly, rather than yearly, they can become aware of their weaknesses and attempt to eradicate them on their own or with the assistance of their coworkers. Another strategy is providing feedback after performing a performance review. Murray (2017) asserts that nurses might view performance reviews as intimidation due to previous negative experiences. Offering feedback regularly through the review period can minimize fear of the process. The manager can review the achievements of the employee and enquire if he or she has attained goals set in the preceding performance review. A nurse manager can reduce a biased rating by seeking input from the staff and try to reach an agreement.


Hess, M. (2012). Shine! Healthcare Leadership Distilled: Increase Your Bottom-line Through Improved Leadership. Bloomington: AuthorHouse.

Murray, E. (2017). Nursing Leadership and Management: For Patient and Safety and Quality Care. Philadelphia: F.A. Davis.

Nikpeyma, N., Abed-Saeedi, Z., Azargashb, E., & Alavi-Majd. (2014). Problems of Clinical Nurse Performance Appraisal System: A Qualitative Study. Asian Nursing Research, 8(1), 15-22.

The face-to-face performance review is one part of performance management. Observing an employee, and then sitting down to discuss areas of strength and need is intended to produce constructive outcomes. Yet, too frequently, the reality falls far short.

Photo Credit: Getty Images/iStockphoto

When considering performance reviews, “positive” or “negative” does not refer to the substantive evaluation but to how the information is presented and discussed. For example, in a “positive” performance review, negative information is not avoided and, significantly, not communicated in a punitive way or as a reflection on employee character. Rather, negative information is detailed as an opportunity for improvement.

For this Discussion, you will reflect on circumstances and behaviors that can lead performance reviews awry, and how to support a review process with constructive outcomes. Improvement vs. Fear Through Performance Reviews in healthcare essay

To Prepare:

Review the Learning Resources on performance reviews and appraisals. Pay particular attention to the media programs for potential problems and solutions to consider.
Consider the benefits and drawbacks of performance reviews and appraisals.
What are the characteristics of a positive and effective performance review? What factors create a performance evaluation that contributes to improved performance, rather than injecting fear and self-protection in the workplace? In what ways can performance reviews impact the effectiveness of employees and the healthcare organization?
Draw on the Learning Resources, as well as your own experiences with performance reviews in healthcare settings, to consider how to avoid performance reviews that provoke fear and how to ensure a process that supports performance improvement through openness, honesty, and collaborative problem solving.
Consider insights from your Module 3 Assignment interview to apply to the Discussion, such as examples of criteria used to evaluate employee performance, and if and how that criteria is communicated to employees.
By Day 3 of Week 6
Post the following:

A brief description of factors that contribute to generating fear in employee performance reviews in a healthcare setting. Include examples from your own experience, and/or those of colleagues and other acquaintances, of positive or negative performance reviews. Explain strategies to eliminate fear and to develop and implement constructive reviews that improve performance. Support your post with the Learning Resources or current literature. Improvement vs. Fear Through Performance Reviews in healthcare essay
Fried, B. J., & Fottler, M. D. (Eds.). (2018). Fundamentals of human resources in healthcare (2nd ed.). Chicago, IL: Health Administration Press.

Chapter 6, “Organizational Development and Training” (pp. 150–173)
Chapter 7, “Performance Management” (pp. 174–204)
(Previously read in Week 5)
Bingham, J. B., & Beer, M. (2012, July). HBS case collection: Performance management at Vitality Health Enterprises, Inc. Brighton, MA: Harvard Business Publishing.

Culbert, S. A. (2008, October 20). Get rid of the performance review! The Wall Street Journal. Retrieved from

Simons, R. L., & Kindred, N. (2017, February). HBS case collection: Doverent. Brighton, MA: Harvard Business Publishing. Improvement vs. Fear Through Performance Reviews in healthcare essay

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