Shaming Feedback vs Growth feedback - take homes from Duolingo.

Can we talk all things feedback? Feedback can be beneficial for doctors to gain awareness of strengths and opportunities for improvement.  As physicians that went through innumerable tests and critiques before and during medical school, throughout training, and in ongoing board certification and quality measures, we can fall into some unhealthy patterns around evaluations.  The impact of any feedback actually depends, not only on the methods and the giver, but on how it’s received. 

 

Thankfully over the last few years, there has been an emphasis on quality feedback processes in residency training.  I personally feel it’s better than 20 years ago - intentional encouragement for feedback to be specific, timely, positive and constructive, involving the self-reflection of the resident, with mutually designed goals and action plans. I also know in the world of academics, it’s not perfect every time.  But the effort is in place. So, this...

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Diving into perfectionism

How many of you in residency feel (felt) that perfection is (was) your standard?  Do you recognize the sensation of defeat or inadequacy when you realize you didn’t execute something flawlessly? Do any of you ruminate on constructive feedback as evidence of failure? For those who are parents, do you always feel less than? Maybe you can glean a couple of small tips from my past growth lessons. (I like that word better than failures).

 

As a married resident with 2 children and a husband who was also in residency, I realized in order to survive, I quickly had to loosen some standards. 

 

The first one to go was the house.

 

A perfectly organized and clean home just couldn’t take priority. Cleaning floors, windows, dusting, went to the bottom of the to do list that was never completed. We had bare minimum standards: dishes had to be at least rinsed off while awaiting washing, clothes had to be in clothes bins and not on the floor, toilet stayed...

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Guilt as a resident physician

Let’s talk guilt.  Many in medicine excel in this emotion, especially residents. Mom guilt. Partner guilt. Friend guilt. Doctor guilt.  Food guilt. Work-out guilt. It stems from a couple of places. 

 

One root is that many of us high achievers are wracked with perfectionism.  We want to be perfect as a physician – and for family medicine that means cradle to grave, inpatient, outpatient, prenatal care and labor and delivery, rural and urban.  We want to be perfect as a friend, partner, spouse, parent.  We want to be a perfect mentor to students or interns.  We want to be perfect parents, neighbors, community advocates. We may never intentionally think to ourselves – “I want to be perfect” but we show our colors when something we do is “less than.” We think something has gone wrong. We are very hard on ourselves.

 

Perfectionism is a close cousin of a “should/shouldn’t”...

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What is physician coaching?

Coaching has been around in other fields for a couple of decades. Leaders in the C-suites of large corporations have long-since used coaching to keep up their A game. And though a small subset of physicians have found the benefits of coaching over the years, it was only in the last 5 years that data has been published about the benefits of physician coaching. The most well known study, released August 2019, showed decreased emotional exhaustion, decreased burnout, increased resiliency, and increased quality of life with physician coaching. https://pubmed.ncbi.nlm.nih.gov/31380892/

Let's talk about what coaching is and what it's not.  

First what it's not - coaching is NOT therapy. It is not advising - advisors give advice - they guide, direct, and steer.  It is not mentoring.  Mentors are people the physician naturally looks up to and wants to emulate.  

Coaching is officially defined as "partnering with clients in a thought-provoking and creative process...

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