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1/
End of Rotation Feedback:
Quiet room. Very last day. You said:
“Your presentations were disorganized at times. And I expect students to be more independent at this point.”
Ok.
“You have some gaps in your knowledge. I want to encourage you to read more.”
Ok.
End of Rotation Feedback:
Quiet room. Very last day. You said:
“Your presentations were disorganized at times. And I expect students to be more independent at this point.”
Ok.
“You have some gaps in your knowledge. I want to encourage you to read more.”
Ok.
2/
“Also--I think you dress rather casual for the hospital. I wouldn’t want you to be perceived as unprofessional, you know?”
Swallow. Blink.
“Like, those shoes. Are they sneakers?”
Wait. Huh?
“Um. They’re just comfortable. I mean. . .no, they aren’t sneakers.”
“Well.”
“Also--I think you dress rather casual for the hospital. I wouldn’t want you to be perceived as unprofessional, you know?”
Swallow. Blink.
“Like, those shoes. Are they sneakers?”
Wait. Huh?
“Um. They’re just comfortable. I mean. . .no, they aren’t sneakers.”
“Well.”
3/
Well, what? I wanted to know. You expound.
“Well. You want to look the part. Like a doctor, you know? You want patients to feel like they can trust you when they see you.”
Swallow. Blink. Harder.
“Otherwise, I think you’ll do fine. Just keep reading.”
You smile.
Ok.
Well, what? I wanted to know. You expound.
“Well. You want to look the part. Like a doctor, you know? You want patients to feel like they can trust you when they see you.”
Swallow. Blink. Harder.
“Otherwise, I think you’ll do fine. Just keep reading.”
You smile.
Ok.
4/
After that, you shift to small talk. Like, what rotation are you on next? What state are you from? And, the best one, do you have a dog?
And me, I sat there. Just answering those questions like no big deal:
Surgery. Kentucky. Back home I do. A rescue.
You smile again.
After that, you shift to small talk. Like, what rotation are you on next? What state are you from? And, the best one, do you have a dog?
And me, I sat there. Just answering those questions like no big deal:
Surgery. Kentucky. Back home I do. A rescue.
You smile again.
5/
I’d worked with you for 2 full weeks. Okay, 12 days if you count when I had class. But still. That was a lot of time I thought.
You liked that small talk. One day you asked the team at the elevator if we liked cilantro. Another time we talked about Machu Picchu.
Yup.
I’d worked with you for 2 full weeks. Okay, 12 days if you count when I had class. But still. That was a lot of time I thought.
You liked that small talk. One day you asked the team at the elevator if we liked cilantro. Another time we talked about Machu Picchu.
Yup.
6/
And all of that was cool, because it eased the learning climate. So maybe all that small talk made me think things were going fine, you know?
That and the one time you gave me a fist bump after my presentation on atrial fibrillation.
That was nice.
And all of that was cool, because it eased the learning climate. So maybe all that small talk made me think things were going fine, you know?
That and the one time you gave me a fist bump after my presentation on atrial fibrillation.
That was nice.
7/
Beyond that, you gave me no real feedback. All I could do was try to decipher what you didn’t say. Look to see if your brow might furrow or rise as a clue. Otherwise, I got nothing.
Except the nice fist bump.
I presented to you every day.
(And wore those same shoes, too.)
Beyond that, you gave me no real feedback. All I could do was try to decipher what you didn’t say. Look to see if your brow might furrow or rise as a clue. Otherwise, I got nothing.
Except the nice fist bump.
I presented to you every day.
(And wore those same shoes, too.)
8/
You were still talking. Telling me of something that happened when you were a med student and asking how often I get home to Kentucky.
“Every few months.” I smiled. Though I just wanted you to wish me well and let me go.
Go to read.
Get organized.
Get new shoes.
Cry?
You were still talking. Telling me of something that happened when you were a med student and asking how often I get home to Kentucky.
“Every few months.” I smiled. Though I just wanted you to wish me well and let me go.
Go to read.
Get organized.
Get new shoes.
Cry?
9/
My issue wasn’t the feedback. It was not.
It was that you saved it all up for a sucker punch on the last day. Offering me no chance to autocorrect or step up. Using all your breath on queries about who has the best Korean BBQ and how I felt about the new Lion King movie.
My issue wasn’t the feedback. It was not.
It was that you saved it all up for a sucker punch on the last day. Offering me no chance to autocorrect or step up. Using all your breath on queries about who has the best Korean BBQ and how I felt about the new Lion King movie.
10/
Wait. I take that back. It was the feedback. And the timing, too.
I wonder: Did you want me to be better? To win?
I have two favorite Korean BBQ spots. And the talking animals in the new film were just weird.
I wish this other stuff you're saying could’ve come up, too.
Wait. I take that back. It was the feedback. And the timing, too.
I wonder: Did you want me to be better? To win?
I have two favorite Korean BBQ spots. And the talking animals in the new film were just weird.
I wish this other stuff you're saying could’ve come up, too.
11/
So what even counts as feedback? One (epic) throwback paper said this:
“an informed, nonevaluative, objective appraisal of performance intended to improve clinical skills”
(Ende J. Feedback in clinical medical education. JAMA. 1983;250:777–781)
Hmmm.
So what even counts as feedback? One (epic) throwback paper said this:
“an informed, nonevaluative, objective appraisal of performance intended to improve clinical skills”
(Ende J. Feedback in clinical medical education. JAMA. 1983;250:777–781)
Hmmm.
12/
Another more recent one broke it down further:
“a supportive conversation that clarifies the trainee’s awareness of their developing competencies. . .”
But wait. There's more.
(They had more than 280 characters to say on feedback.)
Another more recent one broke it down further:
“a supportive conversation that clarifies the trainee’s awareness of their developing competencies. . .”
But wait. There's more.
(They had more than 280 characters to say on feedback.)
13/
“. . enhances their self-efficacy for making progress, challenges them to set objectives for improvement, and facilitates their development of strategies to enable that improvement to occur”
(Lefroy J et. al. Perspect Med Educ. 2015;4:284–299)
Hmmm.
“. . enhances their self-efficacy for making progress, challenges them to set objectives for improvement, and facilitates their development of strategies to enable that improvement to occur”
(Lefroy J et. al. Perspect Med Educ. 2015;4:284–299)
Hmmm.
14/
I think I’m hung up on these parts: “intended to improve” and “enable improvement.”
Hearing that stuff on the last day? I never had a chance to make a comeback, man. Or improve.
Like, my mom didn’t wait until after a meal to say to close your mouth while chewing.
Feel me?
I think I’m hung up on these parts: “intended to improve” and “enable improvement.”
Hearing that stuff on the last day? I never had a chance to make a comeback, man. Or improve.
Like, my mom didn’t wait until after a meal to say to close your mouth while chewing.
Feel me?
15/
I was fine with the banter about Korean BBQ and Lion King.
Machu Picchu was cool, too.
But may I offer YOU some feedback?
While you’re working to build up the learning climate? Don’t forget to build up the learner, too.
Okay?
I was fine with the banter about Korean BBQ and Lion King.
Machu Picchu was cool, too.
But may I offer YOU some feedback?
While you’re working to build up the learning climate? Don’t forget to build up the learner, too.
Okay?
16/
P.S. I don’t like cilantro. But I do want to get better.
Thanks.
#meded #feedback #enableimprovement #bekindtoo
*based on a true story
P.S. I don’t like cilantro. But I do want to get better.
Thanks.
#meded #feedback #enableimprovement #bekindtoo
*based on a true story
Disclaimer:
I'm not the student. Though I experienced things like this in the past, this was based on stories from learners I advise. It also reminds me of the times when I, as a faculty, neglected to be transparent & timely with feedback. Writing in first person helps me see.
I'm not the student. Though I experienced things like this in the past, this was based on stories from learners I advise. It also reminds me of the times when I, as a faculty, neglected to be transparent & timely with feedback. Writing in first person helps me see.
