How to write an essay on factors that contribute to generating fear in employee performance reviews in a healthcare setting

How to write an essay on factors that contribute to generating fear in employee performance reviews in a healthcare setting

Performance Reviews and Appraisals

The growing healthcare challenges today have put pressure on managers to monitor and evaluate human resources. Performance management is one of the key strategies used in every organization to assess the quality of work offered by employees and formulate training plans for quality improvement purposes. Performance management represents the process of continuously identifying, measuring, and improving the performance of individuals by aligning performance activities with the strategic goals of the organization (Simons & kindred, 2017). Performance appraisal is a component of performance management that involves assessing the performance of workers. Appraisals are performed to determine the professional competence of workers, enhance development, and motivate employees towards the higher achievement (Culbert, 2008). Although performance appraisals are beneficial, employees find it difficult to complete them because of bias and issues with accuracy. Nurse managers should assess factors that contribute to performance appraisal issues and use appropriate strategies to improve this aspect of management.

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

Performance appraisal does not always increase productivity due to the presence of setbacks within healthcare organizations. One of the factors observed to create fear among employees is the lack of valid appraisal tools (Culbert, 2008). The majority of the organizations lack protocol and appraisal tools that define measures used to assess the employee’s performance. Because the tools used are not valid, the issue of bias makes employees fear the whole process. For example, available tools may fail to recognize employees who were always available for their patients and only recognize those who saved lives during emergencies. Secondly, personal relationships between healthcare workers may affect ratings during appraisals leading to poor scores and a lack of recognition for some employees (Bingham & Beer, 2012). On other accounts, the lack of clear and independent performance dimensions on the appraisal tools may render the exercise insignificant to some employees.

The second factor that is observed to cause problems with employee performance appraisal is fear of the unknown. For most employees, appraising their performances means looking for mistakes rather than positives in their areas of care delivery. Some employees are also unsure of the reasons for performance appraisal while others may fail to match the appraisal system with the set organizational goals (Bingham & Beer, 2012). During a self-appraisal, the employees may be confused about how managers expect them to rate themselves. For example, are they testing if I can rate myself high or low? Am I being evaluated on my job description responsibilities or there are other things I should consider? Such uncertainties may cause fear of the unknown among healthcare professionals and make the appraisal process difficult.

The most common cause of performance appraisal problems is a biased rating (Culbert, 2008). Most managers will already have the full picture of the employee’s ratings before the appraisal begins. Some are clouded by the primacy effect which represents the overall impression about the ratee based on particular characteristics (Culbert, 2008). For example, the manager may prefer male nurses to their female counterparts and therefore the male will receive good scores during the appraisal process. Personal biases like in the case when the supervisor dislikes certain employees will definitely contribute to poor ratings.

Poor feedback is another factor that creates fear for the performance appraisal process among employees. For many employees, appraisal time feels like being in a hot seat where their performance is under frequent discussion. They may face challenges with concentrating at work and feels some silent torture when close to their managers (Simons & Kindred, 2017). Feedback, whether good or bad, can be difficult to receive, especially if a lot of time is taken. For example, we once had to wait for one month to receive reviews from the manager and it was a difficult experience not knowing what to expect. During communication of the results, the manager was harsh on those who performed poorly and did not take time to go through what was expected of the employees. Failure to talk about questions of concern from employees during feedback may make subsequent appraisals unpleasant to employees.

Strategies to Eliminate Fear

The first strategy I would recommend is the use of regular evaluations for employees. Regular evaluation can help to reduce fear of the appraisal process by ensuring employees are aware of the process and expectations from their managers (Bingham & Beer, 2012). For example, the organization may consider performing appraisals quarterly rather than annually for nurses. The nurses can easily become aware of their weaknesses and work closely to solve them. The second strategy may involve using standardized appraisal tools all the time to enable employees to work on specific areas of performance. The employees can be educated on what aspects of care are important and what the managers will be looking for during appraisal. Standardization may also help reduce the fear of appraisal by familiarizing employees with the tools and frequently using them to do the appraisals.

Feedback delivery mechanisms can be used as strategies to eliminate performance appraisal fear among healthcare workers (Simons & Kindred, 2017). The managers should provide documented details of the employee’s performance rather than verbal responses that may be difficult to deal with. The managers should take time to discuss the areas poorly performed by the employees and provide mentorship and referral when necessary. Providing such kind of feedback may eliminate fear due to previous negative experiences of employees.


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.

Simons, R. L., & Kindred, N. (2017, February). HBS case collection: Doverent. Brighton, MA: Harvard Business Publishing.

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