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Reduced to tears and triggering defense mechanisms: How to provide effective, meaningful verbal feedback and create learning opportunities Leah Delfinado, MD Associate Program Director Department of Obstetrics and Gynecology Advocate Illinois Masonic Medical Center. No disclosures.

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  1. Reduced to tears and triggering defense mechanisms:How to provide effective, meaningful verbal feedback and create learning opportunitiesLeah Delfinado, MDAssociate Program DirectorDepartment of Obstetrics and GynecologyAdvocate Illinois Masonic Medical Center

  2. No disclosures

  3. Qui tacet consentit

  4. Objectives Why feedback is important Types of feedback Barriers to giving and receiving feedback What does meaningful feedback look like Practice makes perfect

  5. Why feedback is important Critical assessment tool Emphasizes reflective capacity Fosters professional autonomy

  6. Informal vs Formal Assessment

  7. Barriers to giving feedback Fear of upsetting the trainee Trainee is resistant or defensive

  8. Barriers to Receiving Feedback Feedback is too generalized and not related to specific observations Feedback does not give guidance to rectify the behavior Inconsistent feedback from multiple sources Lack of respect for the source of feedback

  9. Giving Effective Feedback Immediate Private Interactive Behavior focused, not personality based Present behaviors, not old ones Give examples Don’t assume motive Offer alternate behaviors

  10. Giving effective feedback Consider your message; 2-3 key points Consider the impact Focusing on overall learning and development within residency, keeps the overall message positive “Sandwiching” information often feels disingenuous

  11. Giving Effective Feedback Encourage self reflection “What do you think you did well?” “What do you think you can improve upon?” May be particularly effective for those trainees you view as defensive

  12. Scenario 1 25yo G1P0 GDM, with poor labor curve delivers a 4200g infant with a 1 minute dystocia at 1am. The PGY 1 pushed with the patient for 90 minutes in the room by herself then called the attending physician when the patient was crowning. The attending took over (when the intern failed to perform any maneuvers) performing a Woods screw with McRoberts and suprapubic pressure.

  13. What feedback would you really like to give? Person A is a senior resident, comfortable with and often asks for feedback. Person B is an intern, clearly uncomfortable with feedback and self conscious with your supervision of their performance.

  14. Scenario 2 You’re assisting a resident with a speculum exam and pelvic exam on a 21yo nullip for her first gynecological visit. You notice the patient is extremely nervous, and she has a hard time tolerating the exam. The resident has 3 other patients waiting at the clinic, hurries through the exam with little communication, and the patient appears to be upset afterwards. The resident leaves the room without addressing the patient’s distress.

  15. Feedback? Person A is someone you’ve given feedback to in the past, and they appeared defensive. Person B is a junior resident who has already been given feedback today by their senior resident, and that exchange ended in tears.

  16. Goals of Effective Feedback Motivate Develop knowledge, skills, behaviors Maximize potential Raise awareness of strengths and weaknesses Identify techniques to improve

  17. Questions, Comments...Or Feedback?

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