Deepening Standardized Patient (SP) Feedback Skills

Report
Deepening SP
Feedback Skills
Feedback Workshop
Standardized Patient Program
Mercer University School of
Medicine
Standardized Patients General
Meeting
August 18, 2009
What is Feedback?
• Dialogue
• Information
• Jumping off point for the learner (rather
than correction)
• Based on communication process
rather than clinical content
2
Why is this so important?
“I definitely appreciated the feedback that
one of my patients gave me. I think that
that was one of the best parts of the
evaluation because it really gave me a
feel of how I did. I do wish, however,
that the other SP would have provided
feedback as well. I hope that SPs are
encouraged to give us feedback
because it’s the most useful part.”
Senior Student at Mercer
3
Characteristics of
Feedback?
• Specific
• Based on observable behavior – what
you saw or heard
• An “I” statement: An objective
statement of your subjective experience
4
“When you said or did ___”
• I felt_________________
• I experienced_________
• I noticed I____________
• I observed I__________
• I was_________________
5
Suggestions
of Giving
Feedback
6
Keep the
feedback in the
first person.
7
Address the
student as a
student, and not a
doctor.
8
Focus on areas of
strength and
areas of growth.
9
Be honest but kind in
the feedback, trying to
cite something positive
especially when there is
much negative to dwell
upon.
10
Refrain from giving back the
checklist; rather concentrate
on behaviors like body
language, voice tone, eye
contact, pace or attitude,
none of which will be
reported to the student by
any other means.
11
Students are coached before the exam, telling them this
exercise is as much about process (being thorough and
methodical, acting sincere and compassionate, etc.) as it
is about content (achieving a high percentage from the
checklist). Feedback needs to reinforce that dictum by
never penalizing a student in the comment section for
failing the checklist. A successful student on the series
of checklist items can give a poor bedside impression.
He or she should receive that feedback in the comment
section. Conversely, a student may really wow you with
social skills that are not reflected in the checklists. Use
these comments to their advantage.
12
Use specific
examples.
13
Give information
as clearly and
respectfully as
possible.
14
Less is more!!
Stay concise – one
to three lines is
adequate for most
cases.
15
Do not compare
students when you
give feedback.
16
Avoid commenting
on medical
content.
17
Avoid using
judgment terms
such as “good/
bad” or
“right/wrong.”
18
Some SPs contrive a list of adjectives
that they find suitable to reflect
positive and negative interpersonal
skills, and then they draw down from
this list in writing feedback. This may
be helpful but should not limit your
comments.
19
Check with the SP Coordinator
if you are concerned about
something you feel compelled
to say to a student. Remember
all comments are being edited
by the director of the program.
20
Remember: You are
there to offer
information. It’s not up
to your job to change
anyone’s behavior.
21
SPs in Action:
Comments on
Feedback
22
“Student was friendly and put
patient at ease. Student was
eager to make patient
comfortable during the physical
exam. Student did a good job
of reassuring patient
concerning possible surgery.”
23
There is nothing I did not like
about this encounter, He was
relaxed, knowledgeable
friendly, empathetic, and
confident..”
24
He offered to talk to
me about anything
without telling my mom
and that made me feel
a little comfortable.
25
I think her plan was to
give me some tough
love and be relatable,
but it didn’t work; she
just started getting on
my nerves.
26
“Made good eye contact, very
pleasant smile which helps relieve
anxiety. Initially she did not sound
like she was going to admit me to
the hospital, however, after
prompting she indicated that she
thought it would be a good idea for
the sake of safety..”
27
“Did not mention my diet at
all, did not tell me to quit
drinking or smoking. Very
possible heart attack, wants
EKG now, may admit after
reviewing results.”
28
“Lorena was impressed with this doctor’s
suggestion to make bedtime less stressful
and more about going to sleep. Good
advice given to the patient. Student did not
ask about the confusion regarding the two
different shoes, although patient kept
swinging her feet. The student did not ask
about the falling history even though the
patient was rubbing her head along the
band aid line.
.”
29
“Very concerned,
friendly, and
empathetic. Great
communication skills!.”
30
“When you left a silence
after you asked me if there
was anything else I needed
to talk about, I was relieved
because it gave me space to
decide to tell you about my
husband’s death.”
31
“When you sat and let
me get upset about my
dad’s death, I felt
supported and listened
to.”
32
“The student
reassured me that it
was good that I called
in. That made me feel
as though I was doing
the right thing.”
33
“Sensed urgency from me.
Non verbally acknowledged
seriousness of situation. Very
confident. My best yet,”
34
“Thomas Caine would return to
see this doctor. He thought the
doctor understood the sensitive
nature of the problem not so
much by what he said but by
his mannerisms.”
35
Timely, constructive feedback is essential
to learning. Yet too often learners don’t get
the feedback they need, and some of the
feedback they get is delivered too late and
in hurtful ways.
36
If learners are to provide high-quality care
throughout their careers, they need to
value feedback and invite feedback from
trusted colleagues.
37
If you help them value feedback and
provide them with useful feedback, they
may well begin reaching out to you and
others for feedback throughout their formal
education.
Fostering Reflection and Providing Feedback
Jane Westberg and Hilliard Jason
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