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

2. 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”

3. 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

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

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

7. 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

8. 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

9. 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:

10. 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?

11. The Pool of Shared Meaning

12. Contrast

13. “STATE”

14. AMPP

15. 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.

16. 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

17. 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?

18. 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?”

19. Thank You!