Trouble Shooting

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Trouble Shooting ConflictResolution Between
Student Preceptor

• Or, how to prevent strangling the student after
  contaminating a whole back table including it
  in the students daily evaluation

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Part 1 Lets First Talk Feedback Without Dread

• Student at beginning of clinical rotation cant
  improve with little to no guidance, or
• Cant improve if not allowed to do anything
• Providing a blanket eval is not accurate
  reflection of performance

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Be Factual Specific

• Factual evals not based on opinion or personal
• Define bad attitude
• Specific as possible so student knows skills that
  need improving along with praise

4
DESC Communication Model

• Describe
• Effect
• Solution
• Consequence

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Describe

• Describe behavior or skill that needs improvement
  or changing
• Avoid pitfalls when evaluating presuming
  conclusions, motives, attributes regarding
  behavioral issues, e.g., again bad attitude

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Effect

• List the effects of the behavior or skill
• Negative consequences that could result if
  improvement is not made
• How patient surgical team could be affected,
  e.g., safety issues

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Solution

• Outline solution
• Challenge student to arrive at solution
• Aid student in arriving at solution
• Behavioral issue solution should outline what is
  expected starting the next day

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Consequences

• Define consequences
• Explain in detail consequences if behavior is not
  corrected or skills not improved upon

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Preceptor Concerns

• Dont want to look like the bad guy
• Uncomfortable with confronting student
• Preceptor must accept fact failure to fulfill
  Preceptor role in providing accurate feedback
  allows poor performance to continue
• Must not dread or fear giving student
  constructive, factual feedback

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Part 2 Conflict Resolution

• Dealing w/ Challenging Student Red Flags
• Disorganization
• Inconsistent performance, e.g., continual breaks
  in aseptic technique
• Deficiencies in basic skills
• Overly nervous
• Unreliable
• Lack of exercising caution/safety skills
• Denial of errors defensive lack of accepting
  positive critique argumentative

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4 Es of Constructive Feedback

• Engage
• Give feedback only when there is a constructive
  outcome you want to achieve
• Giving feedback on the spot quickly frame it in
  terms of what you want to improve or change, but
• You dont need to announce it to the whole world
  in the O.R.

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4 Es of Feedback cont

• Empathize (to a certain degree)
• Remember when you were a student time to stop
  eating our young during clinical rotation
• Focus on facts
• Use active listening skills when student is
  working their way thru problem solving guide
  the student
• Determine best time place to talk with student,
  e.g., on the spot correction or private area
  after procedure

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4 Es of Feedback cont

• Educate
• Describe observation to student impact on team
  patient
• Aid student is figuring out how to improve
• Focus on situation or behavior, not the person
  do not make it personal
• Remain objective/factual
• Give examples

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4 Es of Feedback cont

• Enlist
• Ask for students feedback response
• Use critical thinking/probing questions to make
  student think hard
• Listen summarize discussion
• Establish mutual goal mutual goals can often be
  arrived at do not necessarily have to be
  dictatorial
• Student accountability follow-up

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Not Getting Anywhere Legalities

• Just not getting thru to student
• Behavior(s) continue
• Skills dont improve
• Steps to Take
• This is when open, honest student evals are
  valuable that have been discussed with the
  student provided to program director
• Talk to program director
• What are the potential legal issues to think
  about?

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Scenario Time - Handout

• Group Activity
• Group 1 Scenario 1 The Seasoned Student
• Group 2 Scenario 2 The First Total Joint

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