Growing Pains

Yesterday I got some unexpected, negative feedback at work. A combination of poor delivery, fatigue, and some shouldering burnout caused the 2-minute encounter to subsequently ruin my day. As a resident, receiving constructive criticism is part of the job description, but some days are more palatable than others.

What follows is some advice to myself and anyone else who finds themselves in a similar situation!

Dear trainees

Give yourself some grace. Medical school is hard. Residency is hard. Going to a new job site every month, each that demands a different skill set, is hard.

Growth is a part of the process. You’re in training for this reason! Understand that if people are giving feedback, they care enough about their job to want to see it done well. While criticism can sting, apathy is worse.

Understand that feeling bad about what happened is a sign that you take pride in your work, and value a job well done. You’ve come this far- be confident in your capability to be a good doctor. Use that energy to come up with effective solutions to avoid repeating the same mistake again.

Reach out to other mentors to talk about your experience. One aspect of my program I really appreciate is that I have a ton of upperclassmen (seniors) and attendings (professors) who I know have my best interests in mind and whom I can be vulnerable with. If it takes a village to raise a child, it takes a city to raise a physician. Don’t try to go it alone!

Repeat after me a quote from the great Nelson Mandela “I never lose. I win, or I learn.”

Dear teachers:

Get to know your trainees – the more established rapport you have with them, the greater amount of of unsugarcoated feedback you’ll be able to dish out and still maintain a healthy learning environment. Avoid “blindsiding” whenever possible. A time and a place for feedback exists – is this the right setting?

On this note, if you don’t know the learner well, ask a colleague who does. Perhaps they can offer insight as to whether the mistake you noticed is typical behavior, or there are extraneous circumstances you’re not aware of. A colleague may even be better suited to deliver the message

Set the stage. Offer a semi-private setting (at least so that the learners peers are not included) as to avoid embarrassing or shaming in front of others. Research has taught us that shame is not an effective teaching tool.

Good feedback is bi-directional. Solicit the perspective of the learner. Perhaps there was a reason why they did things the way they did. Even if the learner has no “excuse” or context for the error, being given a chance to offer their piece builds trust and goodwill.

Remember the “feedback sandwich,” which means giving positive feedback along with the negative. A tiny bit of positive feedback along with the negative changes the entire flavor of the conversation.

Residency is all about growing pains, especially in the earlier years. A day has passed and I feel way better than I did 24 hours ago, thanks to the help of some trusted peers and mentors and a little self-coaching.