Feedback

Mary forgot to mention something that could cause a life-threating disease if not addressed. Both articles this week mention giving feedback immediately or shortly after, but this issue needs to be questioned immediately before the student moves on. Because Mary does usually excel in clinic, I may think she just forgot to mention it to me and got ahead of herself in our discussion. I would ask Mary if there was anything else significant about the answers on the health history. This does give her the idea that there is, but it is acceptable because she either asked the patient or did not ask. If she can reply something to the effect of telling me what time, how many milligrams, what type of pre-med, I would be confident that she did ask and just looked over it in mentioning it to me. For this, I would probably give her a below expectations (going off of OSU’s grading). She did not meet my expectations, because that is one of the first topics a student learns in their first semester. If she failed to ask the patient about the pre-med or failed to realize a knee replacement needed a pre-med, I would have to give her a below standard of care. Because pathogens can cause such serious problems, it would be the standard of care to cause no harm to the patient. After the appointment, I would talk to Mary about the consequences of no pre-med and why I gave her the grade I did. I would try to do that in a ‘feedback sandwich’ that the article calls it, or the oreo effect as I have heard. I may tell her she was very professional with her patient, then tell her about why I graded her as I did, and end with another positive such as great perio assessments. Like the second article says, I may ask her to self-evaluate first to see how she thinks she performed. Another tip in the same article is to make sure I have clarified any questions she may have. This is very important and can be a great learning experience.

Ben… oh boy.

Let’s evaluate this like Ben is in his first semester of clinic. I would start by asking if he explored after he scaled. If he said yes, I would give him another chance and remind him to explore slowly with a light grasp. I would watch as he did this and give him any feedback, so that it is done in a timely manner, like mentioned in the first article. I would then point out areas for him to explore and feel to make sure he feels it and knows what he is looking for. I would give him the chance to remove the rest of the deposits. I would give Ben a meets expectations in this case. Although seven is a lot of spots, this is a great learning opportunity. If this is his first semester in clinic, he may have never really felt calculus until now. I know it took me a LONG time to be able to feel calculus. I just scaled and scaled and hoped it was all removed.

Now, if Ben is in his last semester, this is a completely different story. I would still send Ben back to the spots he missed and make sure he could feel them. I would then have him remove them and sit down and re-check. I would not give him a second chance without penalty. Because he is about to be on his own in private practice, I would have to give him a below standard of care. It can be harmful to the patient to leave that many pieces of calculus.

In either scenario, I would use the Pendleton Model with Ben. I would have him state some of his positives for the day, and give him some of mine. I would then have him critique himself, and I would then give my negative feedback. This would have to be done in proper terms and in small bits, as the article says. I would not mention too many negatives at once and try to end on a positive note.