Difficult feedback - realistic
This is the realistic script, under development. Click here to read the original scenario submitted by LauraS, as well as the comments and votes.
INT. PHYSICIAN'S OFFICE - OFFICE HOURS
PRECEPTOR sits behind desk with open file in front of her, while RESIDENT sits at front of desk.
PRECEPTOR
Hi James... So, as you know, we're here to run through your evaluation for this rotation..
RESIDENT
Yeah, that's right (looking a bit nervous - or potentially hopeful)
PRECEPTOR
So I've got your In-Training Resident Evaluation form here... and unfortunately, it looks like you are not going to pass this rotation.
RESIDENT
Pardon?.. Oh... (a bit shakey)
PRECEPTOR
Well, I've had to grade your work as Below Average on a number of criteria in most of the core competencies. And as Unnaceptable in some key areas..
RESIDENT
I - I don't know what to say. I mean, I've passed all my other rotations with no problems... And, we had a meeting about a week ago, and I thought everything was going ok.
PRECEPTOR
Well, that's just the thing. We had that that talk last week, and I gave you some feedback about specific areas of improvement. But then this week, (incident) happened, and I heard you say (something) to Dr. Conner.
I have had to give you an unnacceptable grade in the "Progress Since Last Meeting" section. I'm afrain your work is substandard.
RESIDENT
Look Dr. Behr, I don't think this is very fair. When we met last week, you told me of some areas of improvement, but I had no idea that mywhole rotation was on the line!... I mean, if it were that serious, surely you could have warned me?
PHYSICIAN
I did warn you, James. I told you (some thing that the RESIDENT could interpret as ambiguous but the PRECEPTOR) understands as serious), and about how improtant this is for patient care in this sub-specialty. You didn't show that you could (improtant skill), so I just can't pass you.
RESIDENT
Wow, this is really upsetting... and really not fair! I'm really not sure what to do here
PRECEPTOR
Well, as I mentioned, I did warn you, and give you a chance to improve. I think that your best option would be to (?)
RESIDENT
(visibly upset, downtrodden) OK, I'll do that. Thanks Dr. Behr.
Script type:
realistic
What's happening?
Feb 22 2012 (All day)
Nov 12 2011 - 9:30am
Comments
Sketching the characters and context
PRECEPTOR is traditional physician, inclined to formal authority. Feels RESIDENT has not adequately attended to her prescribed methods.
RESIDENT favours independent learning. Final year of residency. Previous rotations with different preceptor were notably successful.
PRECEPTOR uses rote interview process to deliver news that RESIDENT will not pass rotation.
Would like to capture the ambiguity that RESIDENT has legitimate perspective that she should pass rotation (mature, demonstrate Bordage level 4, previous success); while PRECEPTOR has legitimate perspective that RESIDENT should not pass rotation (not following directions, lacks respect for traditional methods).
need: example incident - time-sensitive ambulatory care procedure? - to embody the mismatch in their relationship: PRECEPTOR advised a standard course of action, RESIDENT took another (unconventional) course. Was successful, but deemed risky by PRECEPTOR. Discussion of rotation failure makes reference to this incident from both points of view
Realistic:
PRECEPTOR dictates the result evaluation
RESIDENT challenges
PRECEPTOR overrules
A denial and a defensive
A denial and a defensive attitude is much more common in my expereince than an "OK" at the end of such a conversation