Teaching Crucial Conversations Skills to Residents 52nd STFM Annual Spring Conference Seminar Presented by Lenny Salzberg, M.D. and Matt Martin, Ph.D.

Goals: By the end of this seminar, participants will be able to: State the three components of a “Crucial Conversation” List common crucial conversations in residency programs Apply “contrasting”, “state”, and “ampp”

Disclosures: Dr. Lenny Salzberg is a “Crucial Conversations Trainer” Dr. Lenny Salzberg teaches these concepts in a Chief Resident Workshop Dr. Matt Martin has a cushy life as an academic, and no longer does direct patient care

What makes a “Crucial” Conversation different? High Stakes Opposing Opinions Strong Emotions

Why should you care? When it matters most, we do our worst Fight or Flight Reptile brain

Common Crucial Conversations Ending a relationship Confronting an offensive coworker Asking a friend or relative to repay a loan Giving your boss difficult feedback Talking to someone who isn’t keeping commitments Discussing problems with sexual intimacy

Common Residency Crucial Conversations Think about a residency-related crucial conversation you’ve had in the last month Think about a residency-related crucial conversation that you could have had in the last month, but didn’t Pair up with a person near you Discuss with your partner Be prepared to share with the large group

Common Residency Crucial Conversations Evaluations: Rotations Quarterly Evaluations CCC Meetings Your resident needs to be fired You have an impaired coworker A resident/ colleague/ subordinate isn’t keeping commitments Your boss needs feedback Other:

How to recognize when conversations become crucial Where do you feel stress? Do you fight or flee? Do you feel stuck or don’t know where to start?

The Pool of Shared Meaning

Contrast

“STATE”

AMPP

Triads It is now time to practice what you have just learned by completing 9 role plays (numbered one through nine) Break into groups of 3 Choose who will be person A, who will be person B, and who will be person C Start with “Role Play 1” Each role play should take 3 – 4 minutes After completing role play 1, move on to role play 2, then role play 3, etc.

Triads In role play one: Person A will be “you” Person B will be “Steve” Person C will be an observer Your job will be to give feedback to “Person A” Pay attention to fidelity to the model Ask “Person B” if this was effective There are 3 role plays for each skill Rotate roles for each skill, so that every member of your triad is practicing the skill once, is observing once, and is giving feedback once

What could have gone better and why? Debrief What went well and why? What could have gone better and why? What would you do differently next time?

Common Concerns “It feels artificial” “Do we have to say “don’t” first followed by “do””? “It feels manipulative and insincere” “Can you combine the tools?”

Thank You!