1/ Receiving feedback is HARD!

It puts into tension two core human needs:
- To grow🪴 & learn🎓
- To be accepted as we are🫂

Today’s #TweetorialTuesday is going to provide tools to navigate this struggle.

Thanks for joining the @MedEdTwagTeam!
2/ This is our last thread in our #Feedback series (except for a recap next week), and we have saved the best for last.

Many argue that receiving feedback is the MOST IMPORTANT skill.

YOU are the key variable in whether feedback is internalized and applied, not your teachers.
3/ The content of this thread is derived from the work of the feedback gurus, Sheila Heen & Douglas Stone, law professors at Harvard Law School and experts in leadership, collaboration, and conflict management.

Both their book and this paper are definitely worth your time.
4/ Heen and Stone talk about a lot of different things.

I am going to highlight 5 that I feel are most relevant to the clinical learning environment:
5/ 1⃣“Know thyself” – Socrates

Are you generally an optimistic or pessimistic person? Do you react strongly to praise or criticism? Or do you take most things in stride?

If you know your patterns, remind yourself of them so you can be prepared to act how you hope to.
6/ 2⃣Understand the Feedback – Before we determine feedback is valid & something we should incorporate, we first must understand it.
- Enter with a Curious & Open Mind
- Examine Difference – Data & Interpretation
- Don’t Accept Labels – Where did it come from? Where is it going?
7/ 3⃣See Blind Spots
We judge ourselves on our thoughts/feelings & intentions
Observers judge us on our behaviors, impact on others, & their story about us (their interpretation of our thoughts/feelings & intentions)

Our data is invisible to them. Their data is invisible to us.
8/ Here is a true story to illustrate difficulties understanding feedback & blind spots.

I was really hurt to get this feedback. But after we heard each others' stories and interpretations, we realized I needed to work on my communication, and not my dedication to patients.
9/ Ways to uncover blind spots:
- Observe your reaction
- Look for consistencies
- Get a second opinion
- Record yourself
10/ 4⃣Control Emotions
Perceived threats to our identity heighten our emotions.
- Practice mindfulness – Observe your body & your breathing. Slow things down.
- Shift to your rational brain – Something we do in medicine all the time. Now apply it to receiving feedback.
11/ (emotions continued)
- Sort towards coaching – Even if the feedback you are getting is summative/evaluative, put it in the coaching bucket as something that you can use to improve.
- Separate feeling, story, & feedback (see below).
- Give yourself a second score (see below).
12/ 5⃣Be Vulnerable

Our relationships are affected by how we respond to feedback.

When we are vulnerable & share our journey, it allows people to know us better & form stronger connections.

We develop humility, authenticity & confidence.
They feel respected & appreciated.
13/ Again, many argue that how one receives feedback is FAR more important than the way it was delivered.

The five facets of feedback reception I highlighted today were:
14/ Today was the last #Feedback thread. Thank you so so so much for joining us on this adventure! We loved interacting & learning from you.

Next week, @JenniferSpicer4 will summarize all we have covered. Then, a new topic!

Follow me, Jen, & the @MedEdTwagTeam to not miss out.

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More from @GStetsonMD

30 Mar
1/ All teachers will have learners who aren’t meeting expectations.

Providing feedback in these situations can be tough, but is VITALLY important.

Hang with us, the #MedEdTwagTeam, and we will walk you through it on today’s #TweetorialTuesday!
2/ Today, we will discuss the “struggling learner”, a terrible phrase that shouldn’t be used.

From now on, we will be discussing the learner who isn’t meeting expectations (LWIME). This doesn’t label, and describes their current behaviors, not their potential.
3/ Can we define LWIME? Per @JenniferSpicer4 & @gradydoctor, you need a measuring stick to say whether a learner is, or is not, meeting expectations.

Great tools are the #ACGME Core Competencies or #CanMEDS Framework. You can further break this down by specialty #milestones.
Read 15 tweets
9 Mar
1/ Formative Feedback? Say whaaaat?

Hey #MedTwitter & #MedEd Friends!

We are the #MedEdTwagTeam back again for another #TweetorialTuesday!

Thanks for joining us!

Follow: @GStetsonMD, @JenniferSpicer4, & @MedEdTwagTeam to stay up to date. Image
2/ Today we are going to be breaking down #FormativeFeedback.

What it is, how we think about it, and how to implement it.

As always, any questions or thoughts, please reply to this thread. We LOVE it! Image
3/ So, what is #FormativeFeedback, you ask?

This is information that is given to a learner that enables them to make needed changes before the end of the course/rotation.

pubmed.ncbi.nlm.nih.gov/22730899/ Image
Read 13 tweets
2 Mar
1/ You've got feedback to give. But how to deliver it?

Hey #MedTwitter & #MedEd Friends!

We are the #MedEdTwagTeam, back again for another #TweetorialTuesday! 🙏 to all who follow, enjoy, and share!

Follow: @GStetsonMD, @JenniferSpicer4, & @MedEdTwagTeam to stay #UpToDate
2/ We have reached Week 4 in our #Feedback threads.

Last week, @JenniferSpicer4 taught us all about the components of effective feedback, including setting, timing, specificity, frequency, and more.

This week we will talk about the two main methods of feedback “delivery.”
3/ So the two main methods are a “download” and a “dialogue.” What do these terms mean?
Read 14 tweets
22 Sep 20
1/ 💭 Did I check the labs? I know they were fine yesterday. What should I say? 💭

As a supervisor, you need to make clear to your learners (1) the right answer is: “I forgot to check them”

And (2) your reaction will be: “No problem. Let’s check them now.”

#MedEd #MedTwitter
2/ Here is where we are in our journey through the #HierarchyOfTeachingSkills.

Remember that this first level of skills is all about #PsychologicalSafety.

Not judging your learners is key to this.

Find our previous threads @MedEdTwagTeam.
3/ I make sure I never judge my learners. But I DO evaluate them and hold them accountable.

To me, these are three different things.

Here is how I define these concepts 👇
Read 14 tweets
8 Sep 20
🙏 @ShreyaTrivediMD! Fascinating questions. My answers:
1. #Hesitations - Two things...
A. Already distracted by phone (email, texts, etc.). Will Twitter make it worse? Answer, yes. However, I try to limit my interactions to specific times, and turn off notifications.
B. I work for the Federal Gov. Outspoken for #Equity #Inclusion #HumanRights #HeForShe #BLM #LGBTQIA.

I worried about violations of #HatchAct.

However, can speak about issues, just not parties or candidates.

However, #45 doesn't care about Hatch Act. Should I?
2. My most meaningful collaboration in my career has come via #MedTwitter. @JenniferSpicer4 and I noticed similar ideas and content from each other, then set up 1 meeting, and @MedEdTwagTeam was born. We have never met in person, but have collaborated weekly for months now!
Read 4 tweets
8 Sep 20
1/ 💭 When should I show up? What if I answer a question wrong? Is my presentation too long? Where’s the bathroom? 💭

Sounds like a case of “New Rotation Jitters”

The Cure - Setting Expectations!

Literally, one of my favorite things 🤓

#MedEd #MedTwitter #MedEdTwagTeam Image
2/ Here is where we are in our journey through the #HierarchyOfTeachingSkills.

Remember that this first level of skills is all about creating #PsychologicalSafety.

If you want to see any of our previous threads, check out the @MedEdTwagTeam account. Image
3/ Setting clear and explicit expectations is a key teaching skill that will pay numerous dividends.

And like much of teaching, there is an art and a science. Image
Read 19 tweets

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