Tips for IM ward attendings – Chapter 19 – the attending as coach #meded

Today I have been listening to a podcast featuring a boxer.  This boxer discusses coaching and its importance. Anyone who has competed in a sport can relate to the importance of accurate coaching.  Coaching requires immediate feedback, both positive and negative.  The feedback works best when you receive it immediately after you perform. What do learners tell us?  They want feedback, specifically feedback on how to improve.  Therefore, during clinical teaching we owe our learners clear actionable feedback. The first thing we should do is explain that we are giving feedback.  Many years ago, I thought I was giving feedback, but the learners did not interpret my critiques as feedback, rather as a critique.  Now this difference seems semantic, but semantics matter. You have a new medical student who is getting ready to present to you for the first time.  First, I explain how I want the HPI presented.  Then I tell them that I have low expectations of their first presentation, and our goal is to make the second presentation very good and the third presentation excellent.  I tell them that we will stop after the HPI for feedback and questions. Sometimes I restate the HPI, sometimes I ask the team what information was not said out loud.  We discuss the philosophy of a good HPI presentation. I make clear that there is a difference between collecting the history and relevant data and presenting that same information.  So the feedback does not relate to their data collectio...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs