Patient Lists as Feedback Tools

One strategy used by several of our faculty is to keep a running list of patients seen on a shift with a few notes about their presentation, ED course, and any feedback or teaching points for the team. A list of this sort has multiple benefits:
 
DURING THE SHIFT
 
We all get busy; keeping a list will help you prioritize teaching. Have you been doing direct observation or identifying teaching points over the course of the shift? Use a list to keep track and hold yourself accountable - and to remember what that feedback actually was when the time comes to deliver it.
 
Providing patient-specific examples when providing feedback or teaching is more helpful to the learner than general recommendations. Your discussions will be more memorable when framed with relevant stories and recent experiences.  
 
AFTER THE SHIFT
 
Running through the list of patients seen at the end of the shift is a great way to start a debrief with the learner. What went well about each case? What would they change in the future? Often, a list-based debrief discussion will uncover learner questions and insights that may not have been apparent to either of you in the moment.
 
By the way, if you forget to keep a list during the shift but still want to be able to use a list for debriefing purposes, running a report of “My Patients in Last 24 Hours” in Epic can provide you and/or the resident with this information. Did the number of patients the resident saw align with their goals and/or meet expectations for their level of training? 
 
Assuming you kept notes, the end of shift is also an opportunity to address feedback and teaching points that for whatever reason were not discussed in real time.
 

(Don't forget to prime your learners for deliberate practice by asking what they will do differently - or the same - in the future.)
 
AFTER AFTER THE SHIFT
 
If you did not complete your MyTipReport evaluation in real time, your annotated patient list is an awesome cheat sheet for shift evals! Including detailed examples helps create relevance for learners and context for the Clinical Competency Committee.

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