Re-upping the latest excellent #feedback thread from @GStetsonMD@MedEdTwagTeam, and emphasizing this point- someone is not a 'struggling trainee' or, even worse, 'the difficult trainee'. ๐คจ #MedEd#SurgEd 1/6
A trainee not meeting expectations reflects on the unit as much as the trainee. Our local saying is 'not a trainee to fail until they are a *properly supported* trainee to fail'. Importantly, this does not mean the support provided to the last successful trainee is sufficient.2/6
Recall the difference between equality and equity. Teaching cannot be 'one size fits all'. Teaching must be tailored to prior knowledge, learning opportunities, learning goals, preferred ways of communicating, and much more*. 3/6
In more than 3 decades of teaching (bc I was *that* Asian kid with the piano diploma before they left high school ๐คฃ) there have been very few learners who could not reach the standard if you leave time and space for the stuff below the waterline. #DiversityIceberg 4/6
There might be lots of valid reasons why the trainee isn't absorbing info, can't concentrate, can't put in the hours, or reacts in different ways (hint- previous trauma can be HUGE). They might not tell you- and btw it's not your place to pry. But you CAN create safe space. 5/6
So, please- not 'the difficult trainee'.
That *actual human being* has succeeded through years of primary, secondary, undergrad, postgrad, specialty selection- to get to where they are. The chance that they are the entire problem is nil.
If you have positional power and want to know if #CultureChange is happening, don't ask peers. You have to ask the least powerful people in the team. 1/5
And don't ask them yourself. In teams with poor culture, team members have learnt to tell leaders what they want to hear.
So the teams with poor cultures are, paradoxically, the ones where leaders will be told that they have a good culture. A great culture. The BEST. 2/5
So as a leader, what can you do?
I find a trusted go-between.Their role is critical. They must be trusted by the least powerful team members, but crucially, they must be *able to speak to you frankly, no matter how ugly the responses, without risking their own job*. 3/5
I was bullied. Still remember the sickening feeling of knowing that I'd eventually have to ask the bully for my assessment. BUT. Each of us has more power than we realise. For the aggressor, simply knowing that *someone else noticed your behaviour* can be surprisingly effective.
We know the negative effects of cumulative microaggressions. Consider the effect of cumulative micro-counteraggressions. The raised eyebrow, the deliberate silence, moving to stand closer to the victim. Fleas can bring down elephants. #BeTheFlea
I understand personal risk. Please don't put yourself at risk. But do it for your juniors. Do it for your peers in other specialties. Do it in groups and when you have allies.