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Example 2
Scenario: Using questions to direct residents’ attention to important Systems-based Practice, Interpersonal and Communication, and Professionalism issues, and to foster Practice-based Learning and Improvement during a Hospice Rotation.
You are the Associate Residency Director responsible for coordinating a Hospice rotation. Although the residents are given goals and objectives for the experience, some residents have commented that they find the rotation “uncomfortable” and are learning very little.
The illustration below describes how you may use questions to clarify learning objectives for shorter, specialized rotations like the Hospice rotation described below. The objectives are that residents will be able to: (1) describe how system policies affect quality of care for the terminally ill (Systems-Based Practice); (2) ask about and respond to patients’ concerns and preferences (Interpersonal and Communication Skills; Professionalism); and (3) analyze and improve residents’ performance (Practice-Based Learning and Improvement).
Illustration:
Carefully-crafted questions may be used to effectively focus your residents’ attention on policies and other important issues, as well as their interactions with patients, attending faculty, and staff. Examples of the kinds of questions that you could use to guide learning during a Hospice experience are:
- Examine the pain management policy at the hospice facility and compare it with your own hospital’s policy. What are your views about the different patient care practices?
- Keep a daily journal, noting the experiences that made you uncomfortable or sad. Consider, for example, the following questions: What was it about this situation that made you sad? How did your feelings affect your interaction with the patient? How could you look at this situation differently so that you could better serve the patient?
The first question directs residents to examine system policies that affect care delivery (Systems-based Practice). The second question addresses Interpersonal and Communication Skills and Professionalism by directing residents to examine, recognize, and manage their own emotional barriers to caring for the terminally ill. The notebook exercise prompts analysis and improvement of practice. (Practice-Based Learning and Improvement.)
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