Effective communication is a cornerstone of professional practice, and two of the most challenging yet crucial skills are giving constructive feedback and navigating difficult conversations. Whether addressing a medication error with a colleague, providing guidance to a student, or discussing non-adherence with a patient, the ability to communicate clearly, respectfully, and effectively is paramount. For PharmD students and practicing pharmacists, mastering these skills is a “transcending concept” that fosters a culture of safety, promotes professional growth, and strengthens interprofessional and patient relationships. This MCQ quiz will test your knowledge on the principles and techniques for giving effective feedback and handling difficult conversations.
1. The primary purpose of giving constructive feedback in a professional setting is to:
- A. Assert your authority and point out someone’s flaws.
- B. Improve performance, guide development, and reinforce positive behaviors.
- C. Fulfill an annual performance review requirement only.
- D. Win an argument.
Answer: B. Improve performance, guide development, and reinforce positive behaviors.
2. Which of the following is a key characteristic of effective feedback?
- A. It is general and vague to avoid hurting feelings.
- B. It focuses on the person’s personality traits.
- C. It is specific, timely, and focused on observable behaviors.
- D. It is always delivered in a public setting to ensure transparency.
Answer: C. It is specific, timely, and focused on observable behaviors.
3. The Situation-Behavior-Impact (SBI) model is a framework for delivering feedback. The “B” (Behavior) component should describe:
- A. Your interpretation of the person’s intentions.
- B. The specific, observable actions the person took.
- C. The emotional impact on you and the team.
- D. A general statement about their performance.
Answer: B. The specific, observable actions the person took.
4. A pharmacist tells a student, “During today’s patient counseling (Situation), you spoke very fast and didn’t pause to ask the patient if they had questions (Behavior). The impact was that the patient looked confused and may not have understood how to take their new medication (Impact).” This is a classic example of which feedback model?
- A. The Feedback Sandwich
- B. Pendleton’s Model
- C. The 5 A’s Model
- D. The Situation-Behavior-Impact (SBI) Model
Answer: D. The Situation-Behavior-Impact (SBI) Model
5. A “difficult conversation” is best defined as a discussion where:
- A. You simply disagree with someone’s opinion on a minor issue.
- B. The stakes are high, opinions vary, and/or emotions run strong.
- C. One person is delivering a formal lecture to another.
- D. The topic is easy and agreed upon by all parties.
Answer: B. The stakes are high, opinions vary, and/or emotions run strong.
6. The “Feedback Sandwich” is a technique where corrective feedback is placed between two positive statements. A common criticism of this model is that:
- A. It is too direct and confrontational.
- B. The positive statements can feel insincere or can dilute the importance of the corrective feedback.
- C. It takes too long to deliver.
- D. It never includes positive feedback.
Answer: B. The positive statements can feel insincere or can dilute the importance of the corrective feedback.
7. When preparing for a difficult conversation with a colleague, the most important first step is to:
- A. Assume the colleague has negative intentions.
- B. Practice your confrontational opening line.
- C. Clarify your own purpose for having the conversation and gather objective facts.
- D. Involve a supervisor before speaking to the colleague.
Answer: C. Clarify your own purpose for having the conversation and gather objective facts.
8. Using “I” statements (e.g., “I am concerned because…”) instead of “You” statements (e.g., “You always make mistakes…”) in a difficult conversation is effective because it:
- A. Establishes your authority over the other person.
- B. Expresses your perspective and feelings without blaming or accusing the other person, which can reduce defensiveness.
- C. Is a way to avoid taking any responsibility.
- D. Makes your argument sound weaker.
Answer: B. Expresses your perspective and feelings without blaming or accusing the other person, which can reduce defensiveness.
9. Which of the following is a recommended strategy when receiving constructive feedback?
- A. Immediately argue and defend your actions.
- B. Listen actively, ask clarifying questions to ensure understanding, and thank the person for the feedback.
- C. Blame someone else for the issue.
- D. Ignore the feedback if you disagree with it.
Answer: B. Listen actively, ask clarifying questions to ensure understanding, and thank the person for the feedback.
10. A pharmacist needs to address a technician’s repeated errors in filling prescriptions. Which opening statement is most appropriate for this difficult conversation?
- A. “We need to talk. You’ve been making way too many mistakes.”
- B. “Why can’t you get this right?”
- C. “I’d like to chat for a few minutes about the workflow for prescription filling. I’ve noticed a couple of recent errors, and I want to understand what’s happening from your perspective and work together on a solution.”
- D. “If you make one more mistake, you’re fired.”
Answer: C. “I’d like to chat for a few minutes about the workflow for prescription filling. I’ve noticed a couple of recent errors, and I want to understand what’s happening from your perspective and work together on a solution.”
11. The term “actionable” feedback means the feedback:
- A. Is focused on a personality trait the person cannot change.
- B. Provides specific information that the recipient can use to make a change or improve their performance.
- C. Is delivered with a tone of anger.
- D. Is vague enough for the recipient to interpret in multiple ways.
Answer: B. Provides specific information that the recipient can use to make a change or improve their performance.
12. In Pendleton’s model of feedback, the first step after checking if the learner is ready for feedback is to:
- A. Have the facilitator/preceptor state what went well.
- B. Have the learner state what they think went well.
- C. Have the learner state what could be improved.
- D. Create an action plan.
Answer: B. Have the learner state what they think went well.
13. During a difficult conversation, if emotions (yours or the other person’s) become too high, a useful strategy is to:
- A. Raise your voice to be heard over the emotion.
- B. End the conversation permanently.
- C. Suggest taking a short break to allow everyone to calm down before resuming.
- D. Continue the conversation no matter what to resolve it immediately.
Answer: C. Suggest taking a short break to allow everyone to calm down before resuming.
14. Effective feedback should be focused on behavior, not personality. Which statement is the best example of behavior-focused feedback?
- A. “You are lazy.”
- B. “You are careless.”
- C. “I noticed that the past three inventory reports were submitted after the deadline.”
- D. “You are not a good pharmacist.”
Answer: C. “I noticed that the past three inventory reports were submitted after the deadline.”
15. The ultimate goal of a difficult conversation in a professional setting is to:
- A. Prove you are right.
- B. Reach a mutual understanding and find a constructive path forward that solves the problem while preserving the relationship.
- C. Have the other person admit they were wrong.
- D. Avoid the topic entirely.
Answer: B. Reach a mutual understanding and find a constructive path forward that solves the problem while preserving the relationship.
16. Why is it important for feedback to be timely?
- A. So the recipient does not have time to prepare a defense.
- B. Because delivering feedback months after an event is more effective.
- C. So the recipient can clearly link the feedback to a specific, recent event or behavior.
- D. It is not important; feedback can be given at any time.
Answer: C. So the recipient can clearly link the feedback to a specific, recent event or behavior.
17. “Mutual purpose” is a key element for success in difficult conversations. It means:
- A. You and the other person both want to win the argument.
- B. You both have a shared goal that makes the conversation worthwhile (e.g., ensuring patient safety, improving team function).
- C. You have a purpose, but the other person does not.
- D. The purpose is to determine who gets a promotion.
Answer: B. You both have a shared goal that makes the conversation worthwhile (e.g., ensuring patient safety, improving team function).
18. Active listening is a critical component of navigating a difficult conversation. It allows you to:
- A. Plan your next argument while the other person is talking.
- B. Fully understand the other person’s perspective, which is necessary for problem-solving.
- C. Prove that the other person is not listening.
- D. Interrupt the other person frequently.
Answer: B. Fully understand the other person’s perspective, which is necessary for problem-solving.
19. A pharmacist needs to speak to a physician who prescribed a medication to a patient with a documented severe allergy. The pharmacist’s primary purpose should be:
- A. To prove the physician made a mistake.
- B. To ensure patient safety by resolving the issue collaboratively.
- C. To complain about the physician to the nurse.
- D. To dispense the medication as written to avoid conflict.
Answer: B. To ensure patient safety by resolving the issue collaboratively.
20. A peer pharmacist consistently leaves their work for the next shift to finish. The best initial approach would be to:
- A. Report them to the pharmacy manager immediately.
- B. Complain about them to other colleagues.
- C. Have a private, direct conversation using “I” statements to describe the impact of the behavior.
- D. Leave your work for them to finish as retaliation.
Answer: C. Have a private, direct conversation using “I” statements to describe the impact of the behavior.
21. “I need to talk to you about your unprofessional tone with the patient in room 204.” This feedback is flawed because it is:
- A. Too specific.
- B. A judgment (“unprofessional”) rather than a description of a specific, observable behavior.
- C. Too timely.
- D. Focused on a positive behavior.
Answer: B. A judgment (“unprofessional”) rather than a description of a specific, observable behavior.
22. A better way to phrase the feedback in the previous question would be:
- A. “You were rude to the patient.”
- B. “When you were speaking with the patient in room 204, I heard you raise your voice and say ‘I’ve already explained this three times.’ The impact was that the patient seemed upset and may not ask questions in the future.”
- C. “Everyone thinks you have a bad attitude.”
- D. “You need to be nicer to patients.”
Answer: B. “When you were speaking with the patient in room 204, I heard you raise your voice and say ‘I’ve already explained this three times.’ The impact was that the patient seemed upset and may not ask questions in the future.”
23. When receiving feedback, asking “Can you give me a specific example?” is a good way to:
- A. Challenge the person giving the feedback.
- B. Show you are not interested.
- C. Clarify the feedback and ensure you understand the specific behavior being discussed.
- D. Delay the conversation.
Answer: C. Clarify the feedback and ensure you understand the specific behavior being discussed.
24. The final step in many feedback models and difficult conversations is to:
- A. Agree to disagree and end the conversation.
- B. Have a third party decide who was right.
- C. Collaboratively agree on a plan for moving forward or an action plan for improvement.
- D. Document the conversation for punitive purposes.
Answer: C. Collaboratively agree on a plan for moving forward or an action plan for improvement.
25. A preceptor providing feedback to a student pharmacist should ideally do so:
- A. In front of patients to use them as an example.
- B. Only at the end of the entire rotation.
- C. In a private setting and on a regular, ongoing basis.
- D. Only if the student makes a major error.
Answer: C. In a private setting and on a regular, ongoing basis.
26. The “S” in the SBI feedback model stands for:
- A. Specifics
- B. Situation
- C. Solution
- D. Strength
Answer: B. Situation
27. A major barrier to giving effective feedback is:
- A. The desire to help others improve.
- B. Having too much specific data.
- C. The fear of causing conflict or hurting the other person’s feelings.
- D. The availability of private spaces for discussion.
Answer: C. The fear of causing conflict or hurting the other person’s feelings.
28. An effective strategy for starting a difficult conversation is to:
- A. Begin with a vague accusation.
- B. State your positive intentions and the mutual purpose upfront (e.g., “I’d like to talk about our team communication so we can work together more effectively.”).
- C. Present all your evidence first to overwhelm the other person.
- D. Apologize for bringing up the topic.
Answer: B. State your positive intentions and the mutual purpose upfront (e.g., “I’d like to talk about our team communication so we can work together more effectively.”).
29. Which of the following is an example of providing “reinforcing feedback”?
- A. “You need to work on your presentation skills.”
- B. “During that patient counseling session, your use of the teach-back method was excellent. It really ensured the patient understood her new insulin regimen. Keep doing that.”
- C. “Your work is average.”
- D. “Next time, do it differently.”
Answer: B. “During that patient counseling session, your use of the teach-back method was excellent. It really ensured the patient understood her new insulin regimen. Keep doing that.”
30. A difficult conversation about a colleague’s potential substance abuse problem requires:
- A. Direct confrontation by the entire team in a public setting.
- B. Ignoring the problem and hoping it goes away.
- C. A carefully planned, private conversation focused on specific, observable behaviors (e.g., performance, safety concerns) and referring to appropriate resources (like an employee assistance program), often involving a supervisor.
- D. Gossiping with other colleagues to confirm your suspicions.
Answer: C. A carefully planned, private conversation focused on specific, observable behaviors (e.g., performance, safety concerns) and referring to appropriate resources (like an employee assistance program), often involving a supervisor.
31. The term “objective” feedback means the feedback is based on:
- A. Your personal feelings and opinions.
- B. Hearsay and rumors from others.
- C. Factual, observable evidence and behaviors.
- D. Your interpretation of someone’s motives.
Answer: C. Factual, observable evidence and behaviors.
32. The primary difference between feedback and advice is:
- A. Feedback is always negative; advice is always positive.
- B. Feedback is information about a past behavior and its impact; advice is a suggestion for future action.
- C. There is no difference.
- D. Feedback is only given by supervisors; advice can be given by anyone.
Answer: B. Feedback is information about a past behavior and its impact; advice is a suggestion for future action.
33. What is a potential negative outcome of poorly handled difficult conversations?
- A. Improved team morale.
- B. Damaged professional relationships and unresolved problems.
- C. Increased productivity.
- D. Enhanced psychological safety.
Answer: B. Damaged professional relationships and unresolved problems.
34. A pharmacist must talk to a patient about their consistent non-adherence to their heart failure medications. A key component of this difficult conversation is:
- A. Scolding the patient for their irresponsible behavior.
- B. First seeking to understand the patient’s perspective and barriers to adherence in a non-judgmental way.
- C. Refusing to dispense the medication until they promise to be adherent.
- D. Simply telling them they must take the medication.
Answer: B. First seeking to understand the patient’s perspective and barriers to adherence in a non-judgmental way.
35. A “crucial conversation” is another term for a difficult conversation. The goal is to create:
- A. A winner and a loser.
- B. An environment of silence.
- C. A pool of shared meaning and dialogue.
- D. An official written report.
Answer: C. A pool of shared meaning and dialogue.
36. When receiving feedback that feels inaccurate, a professional response is to:
- A. Storm out of the room.
- B. Say, “That’s not true,” and shut down the conversation.
- C. Say, “That’s interesting, my perspective on that situation was different. Could you tell me more about what you observed?”
- D. Immediately file a complaint against the person giving feedback.
Answer: C. Say, “That’s interesting, my perspective on that situation was different. Could you tell me more about what you observed?”
37. Ending a feedback session with “Do you have any questions for me?” is important because it:
- A. Concludes the meeting quickly.
- B. Invites dialogue and ensures the recipient has a chance to clarify points.
- C. Puts the recipient on the defensive.
- D. Is a rhetorical question that requires no answer.
Answer: B. Invites dialogue and ensures the recipient has a chance to clarify points.
38. The phrase “seek first to understand, then to be understood” is a core principle for:
- A. Giving a lecture.
- B. Writing a prescription.
- C. Navigating difficult conversations and giving feedback effectively.
- D. Performing a physical assessment.
Answer: C. Navigating difficult conversations and giving feedback effectively.
39. A pharmacist gives feedback to a student: “You seem unmotivated.” What is the primary flaw in this feedback?
- A. It is too specific.
- B. It is a judgment about an internal state (motivation) rather than an observation of a specific behavior.
- C. It is positive reinforcement.
- D. It was delivered too quickly after the event.
Answer: B. It is a judgment about an internal state (motivation) rather than an observation of a specific behavior.
40. To effectively give feedback on a presentation, it is best to comment on:
- A. The presenter’s choice of outfit.
- B. Specific aspects like the clarity of the slides, the pace of delivery, and the handling of questions.
- C. Whether you personally liked the topic or not.
- D. The presenter’s personality.
Answer: B. Specific aspects like the clarity of the slides, the pace of delivery, and the handling of questions.
41. Why is it important to separate feedback on performance from discussions about compensation or promotion?
- A. It is not important; they should always be discussed together.
- B. To ensure the recipient can focus on the developmental feedback without the conversation being dominated by anxiety about pay or status.
- C. To make the meetings longer.
- D. Because compensation is not related to performance.
Answer: B. To ensure the recipient can focus on the developmental feedback without the conversation being dominated by anxiety about pay or status.
42. One of the goals of a difficult conversation about a team conflict is to:
- A. Identify which team member is right and which is wrong.
- B. Move from personal attributions (“He is lazy”) to understanding each person’s contribution to the problem.
- C. Force the team members to apologize to each other.
- D. Disband the team.
Answer: B. Move from personal attributions (“He is lazy”) to understanding each person’s contribution to the problem.
43. A pharmacist needs to deliver difficult news to a patient (e.g., a medication is no longer covered by insurance). A key communication skill is:
- A. To deliver the news quickly and leave the room.
- B. To express empathy for the patient’s situation and collaboratively explore potential solutions.
- C. To blame the insurance company entirely without offering help.
- D. To tell the patient there are no other options.
Answer: B. To express empathy for the patient’s situation and collaboratively explore potential solutions.
44. The SBI model (Situation-Behavior-Impact) is particularly effective for giving feedback because it is:
- A. Vague and indirect.
- B. Descriptive and non-judgmental.
- C. Quick and requires no preparation.
- D. Focused on the person’s intent.
Answer: B. Descriptive and non-judgmental.
45. Before giving corrective feedback, a leader should ask themselves:
- A. “How can I make this person feel bad?”
- B. “Is this feedback truly intended to help the person or the team improve?”
- C. “How can I win this conversation?”
- D. “Is it possible to deliver this feedback via text message?”
Answer: B. “Is this feedback truly intended to help the person or the team improve?”
46. When a team member reacts to feedback with anger or tears, the first step should be to:
- A. Continue delivering the feedback regardless of their reaction.
- B. Become angry in return.
- C. Acknowledge their emotional response and give them space to process it (e.g., “I can see this is upsetting. Let’s take a moment.”).
- D. Immediately retract the feedback and apologize for bringing it up.
Answer: C. Acknowledge their emotional response and give them space to process it (e.g., “I can see this is upsetting. Let’s take a moment.”).
47. Providing regular, informal, positive feedback (“catching people doing something right”) is important for:
- A. Making corrective feedback less effective when it is needed.
- B. Building trust, morale, and making corrective feedback easier to receive when necessary.
- C. Wasting time that could be spent on dispensing.
- D. Creating favoritism within the team.
Answer: B. Building trust, morale, and making corrective feedback easier to receive when necessary.
48. What is a “crucial confrontation”?
- A. A physical altercation.
- B. A conversation that occurs after a promise or expectation has been broken.
- C. A yearly performance review.
- D. A debate about clinical guidelines.
Answer: B. A conversation that occurs after a promise or expectation has been broken.
49. An important skill for navigating difficult conversations is being able to distinguish between:
- A. Facts and stories (your interpretations or judgments about the facts).
- B. Winning and losing.
- C. Speaking and listening.
- D. Your opinion and the correct opinion.
Answer: A. Facts and stories (your interpretations or judgments about the facts).
50. For a PharmD student, the ability to engage in effective feedback and difficult conversations is a key professional competency that directly impacts:
- A. Only their final course grades.
- B. Their ability to work effectively in teams, ensure patient safety, and grow as a professional.
- C. Their knowledge of pharmacokinetics.
- D. Their ability to pass the NAPLEX exam.
Answer: B. Their ability to work effectively in teams, ensure patient safety, and grow as a professional.