How Do We Use the Comment Box? Learning Log Entries How Do We Use the Comment Box? At the last trainers’ workshop some trainers were unsure what to write in the comment box and so we decided to look at this small area together today. ‘Those of us who have done educational supervision are lucky in that we can get ideas from other trainers. Some entries are easier to comment on than others e.g. patient encounters and SEA We have 3 rooms we can use for the group work.

What is the box for? Any guidelines? Are we consistent in its use?

Formal Guidelines None on RCGP None on Deanery Website None in Ram Mehay’s “bible”

So how do we use it? Feedback Skills apply to the comments box! What we do in practice What should we be doing? What I have seen Karen do, what I do and what I have seen other trainers do. Very briefly touch on these 3 points.

Feedback Based on the entry (observation) Practical Timely – yes you do need to read and make comments every week! Concrete and specific Descriptive How they can improve What was done well –be specific. Outline one or 2 points that could help the registrar improve. Be clear what you are giving feedback on. Do we alter it depending on stage of training?

Feedback Continued Focus on the positive Focus on behaviours that can be changed. When giving –ve feedback suggest alternative behaviours Try not to minimise or collude. Encourage them to add entries regularly and not sporadically (adding 60 entries in one go!) and to share them. Re alternative behaviours get them to think of them. Minimising ‘Its not such a big deal, everyone does it at some time’ Collusion ‘ You’re probably right, perhaps I am overreacting’

Karen’s method 3 stars and a wish identify three positive aspects of the work of a peer and then express a wish about what the peer might do next time in order to improve another aspect of the work. 'I want to give you a star for the start of your story and a star for the way you described the house. I wish that you will tell us more about Billy.'

Reflection Unpacking clinical reasoning and decision making Discussing ethical values and beliefs Guiding them in patient care One of the main purposes of feedback is to encourage reflection.

Some suggested phrases Did it go as planned –if not why not? If doing it again what would you do differently? This is what I think you might do differently in the future How did you feel? How do you think the patient felt? What made you think that? What do you think you might try first?

Learning Log Entry Check the accuracy of the matching Base matching on “what did I learn” Encourage them not to overmatch Comment on accuracy of the matching. Correct factual inaccuracies. Give further information. Illustrate with own experience. Suggest further learning. 2-3 headings is probably ideal. Unmatch and help them match if done incorrectly.