The role of conversation
In the recent article, The role of conversation in health care interventions: enabling sensemaking and learning the authors summary states:
The generation of productive conversation should be considered one of the foundations of intervention efforts. We suggest that intervention facilitators consider the following actions as strategies for reducing the barriers that conversation can present and for using conversation to leverage improvement change: evaluate existing conversation and relationship systems, look for and leverage unexpected conversation, create time and space where conversation can unfold, use conversation to help people manage uncertainty, use conversation to help reorganize relationships, and build social interaction competence.
Busy clinicians complain that they don't have time for student teaching, let alone conversations. So lets look at each of the suggestions.
1. evaluate existing conversation and relationship systems
When and where do conversations occur in your practice with staff and colleagues? Do you share lunch or coffee breaks? Are their formal weekly meetings to plan or debrief? How could you bring students into the formal and informal conversations?
2. look for and leverage unexpected conversation
How might scrub sinks, hallways, change rooms, exercise areas offer opportunities for conversations however brief? When might you grab students and head for a shared coffee break? How might you use this time? What other conversations does the student need to have with staff, patients and colleagues?
3. create time and space where conversation can unfold
Where in your schedule might you organize debriefing time? Where might you arrange brief daily planning time to discuss what the student will focus on that day?
4. use conversation to help people manage uncertainty
What cues does your student present when they are unsure, embarrassed, ashamed? How do you debrief crisis, errors and other unexpected events in your practice? How do you help students deal with death and dying? Who is the best problem solver in your group?
5. use conversation to help reorganize relationships
How do you handle conflict in your office? How do you help students develop collaboration skills? Who is the best team builder in your group?
6. use conversation to build social interaction competence
A key skill in being a physician is the ability to manage the office atmosphere so people want to be working with you and for you. How can you role model this behavior to students? Who else is a master at social interaction that you might ask the student to observe?
What other suggestions do you have for implementing these six actions?