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JAAPA Podcast
Peer Feedback: a tool to improve PA, NP, and physician collaboration and clinical practice.
00:31:43
Constructive feedback can be a valuable tool to help improve working relationships among colleagues. In this episode, Martine, Kim, and Joe are discussing with PAs Alexandra Gallant and Laura Erdman the results of...
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- [00:00]
Alexandra Gallant
Foreign.
- [00:06]
Laura Erdman
Welcome back to the podcast.
- [00:08]
Podcast Host
This month we will be discussing a research article titled Peer Feedback, A Tool to Improve pa, NP and Physician Collaboration in Clinical Practice, which was published by Alexandra Gallant, Laura Erdman and colleagues. We have seen over the last few decades an increased use of PAs and NPs on clinical teams, particularly as an integral part of hospitalists and emergency medicine core staff. As a matter of fact, quoting this research article, according to the Society of Hospital Medicine Annual Report, 83.3% of surveyed hospital medicine groups across the United States employ PAs and NPs. This trend creates an opportunity for growth for those clinicians and some important information can be gathered on all the team members clinical skills skills to identify their strengths and weaknesses, which could in turn open the doors for additional training. We all know how valuable constructive feedback can be to improve working relationships among colleagues. Alexandra and Laura and their team were able to initiate a peer feedback platform in the Academy House Flow system in order to improve collaboration among PAs and present physicians. Today we're going to learn more from them. Alexandra and Laura, welcome. Thank you so much for coming onto the podcast with us today. We are very pleased to have you as our guest for this month's episode. However, before we get started with this topic, would you both take a moment to introduce yourselves? Can you guys tell us about your career, where you work clinically, and I would also like to hear one fun fact about you.
- [01:39]
Laura Erdman
Thanks much for having us. We're excited to be here. I'm Laura.
- [01:42]
Alexandra Gallant
And I'm Lexi.
- [01:44]
Laura Erdman
We're both academic hospitalists at University of Colorado Hospital in Denver, Colorado and we both actually split our time clinically on our inpatient services as well as our Oncology Urgent Care and we both have leadership roles within our division. I am the app Schedule lead for our 57 apps and the co Chair for the Division of Oncology Clinical Case.
- [02:05]
Alexandra Gallant
Review Series and I am one of the lead apps for the Division of Hospital Medicine. I'm also a Director of Provider Experience and Wellness and recently became the Director of App Onboarding. Oh, and fun facts. What's our fun fact?
- [02:19]
Laura Erdman
My fun fact is that after this reporting I'm going to get a tattoo.
- [02:23]
Alexandra Gallant
My fun fact is that I read 92 books last year.
- [02:27]
Laura Erdman
Really made me feel bad about how excited I was that I read 12 books last year.
- [02:32]
Podcast Host
Well, in that case I need to up my games in book reading as well because last year I only read 15 books so I see that I'm very behind.
- [02:42]
Co-host or Additional Host
Or you just need to go get a tattoo. One or the other.
- [02:44]
Laura Erdman
Yeah Exactly. I'm, like, off doing other speaking effort.
- [02:49]
Podcast Host
So either way, these ladies are. They're outdoing my skills. I really have to get on the program. What inspired you to conduct this research on PA NP and physician collaboration?
- [03:02]
Laura Erdman
Yeah, this all started back in 2019, January of 2019. And was talking to her about how I didn't feel like our review really captured the work I was actually doing at that time. I'm sure. As is true, as many other academic institutions, our yearly review largely consisted of a platform in which you can upload, like, your QI achievements, lectures you've given, awards you received, leadership roles you've had, papers you've published, articles you reviewed, and those that are really highly clinical or early in their career that may not have taken on a lot of extra projects. It doesn't really capture the work you're doing. You don't get feedback from other clinicians or nurses or team members. Maybe you get like, a occasional, like, patient comment card. But on the inpatient side and those that work in the hospital, that's not as common as I expect it might be if you're in the primary care office and you have a relationship with your patient. So despite taking care of, like, hundreds of patients a year, I just didn't feel like that was, like, reflected in my yearly review. So after sharing my thoughts with her that I felt like this review wasn't really actually reflective of what I was contributing. She was like, well, Laura, I think you, this is a great opportunity for you to find a way to capture some of that work, to find a way to do this. So I left my review thinking, crap, have I just gotten myself into, like, a huge project and I have to figure out a way to capture my clinical work? And walked back over to the hospital. Lexi was on another clinical team on the same floor.
- [04:23]
Co-host or Additional Host
And.
- [04:23]
Laura Erdman
And so I was sitting with her, talking behind my review wing. I was like, I feel like I just might have, like, accidentally taken on something really big. I don't really know what I'm going to do here. And Lexi was like, I think I'd love to work on that kind of project with you. And so thus, the peer feedback, peer feedback idea was born for us.
- [04:40]
Alexandra Gallant
We really feel like physicians, pas nurse practitioners. We're all, I think, considered peers and kind of equal clinicians. And so for us, peer feedback is feedback between any one of those kind of groups of people. We really focus on bidirectional feedback in our division. So that means, like, for us, feedback between our physician colleagues and our NPPA colleagues. So they each have equal opportunity to provide feedback to each other. The way our teams kind of work at University of Colorado is that basically for a clinical stretch, our physicians work Tuesday through Monday and our apps work Monday through Friday. And so there's a four day clinical stretch where our PAS and physicians work closely together. And so for us, at the end of that four day stretch, we wanted our physicians and PAs nurse practitioners to provide feedback to each other at the end of the week on how that week went, what went well, what could have gone better. I found the Society of Hospital Medicine Statistics interesting. Martine and I have both worked as hospitalist PAS for many years. Therefore we definitely understand what kind of teamwork that you're talking about and the challenges that it can pose and also some of the fun parts that come with working with such an integrated team. According to the article that you mentioned.
- [05:54]
Laura Erdman
In your article, more than half of.
- [05:55]
Alexandra Gallant
Hospital medicine groups across the country employ PAs and NPs.
- [05:59]
Laura Erdman
This means that they play a vital.
- [06:00]
Alexandra Gallant
Role in the team. Your platform to facilitate peer feedback hit on a missed opportunity to gather data.
- [06:07]
Laura Erdman
On the working relationship between all of these different players on the team.
- [06:10]
Alexandra Gallant
Can you tell us how you developed the platform and why did you choose.
- [06:14]
Laura Erdman
This method to launch your survey? Well, serendipitously for us, we already had a platform that our entire division was using to give feedback to the different like various learners we have. So we have like an advanced practice fellowship in our group for PAs and MPS are interested in hospital medicine. Being at an academic institution. We have like PA students, med students, residents. So we already were using a platform called my Evals to have the faculty members give feedback back to the learner that they were working with. And so it was a platform that already everyone in the faculty group was integrated into. And we just had to like build another space or another survey free bull tech have where they already. We already had everyone uploaded to it. So it was kind of a natural expansion like what we already had going in the group.
- [06:56]
Co-host or Additional Host
That's great. So. So the survey was sent to 101 PA, NP and physician faculty members in the initial focus group. The responses received were reviewed and analyzed. And as a result of this process, you created survey goals and questions. What were the main goals of the survey and some of those questions?
- [07:14]
Alexandra Gallant
Yeah, so kind of before we like dived into creating like our overall goals and questions, we did that needs assessment survey. So that was sent to 101 of our faculty. In doing that, we mostly wanted to make sure that like this wasn't a gap that just Laura and I were feeling and that the rest of our division felt it as well. And overall we learned that 75% of the people who responded to that survey felt like that they received no feedback on their clinical skills after they leave training. So a huge number of the group felt like they were lacking in that kind of feedback that they wanted. And then 97% of the people that replied said that they would be interested in a peer feedback program and thought it would be helpful. So we kind of obtained our buy in first. We then had like a focus group to learn kind of specifically what people would want in a peer feedback platform. And so one thing we learned is that people don't like, like heart scales as far as when it comes to feedback. Like that ranking system is just very, it's not very detailed, it doesn't provide you like very specific information. It's like, oh great, I'm above average on my educational skills or something like that doesn't mean anything. So we wanted more kind of subjective information. And then we learned that it needed to be like very simple, easy questions. And we decided to make it not anonymous. So our surveys were not anonymous. And that was partly because we wanted to make sure the feedback was really timely. And in order to blind something we'd need to wait X number of evals to be filled out before we submitted them to the person. But also we wanted to kind of mimic what should be happening naturally and like you should be providing feedback to your colleagues like at the end of a stretch together. And so we wanted to kind of mimic that kind of natural like feedback process. So after we did the needs assessment survey, our focus group, we created three goals and that was our first goal was to highlight our strengths and encourage each other to engage in ongoing clinical growth. The second goal was to facilitate thoughtful and respectful feedback to our peers. And the third goal was to create a successful and collaborative culture between our peers. So that was the goals of our platform. And then the two questions were what are three things this person does well? What is one thing this person could improve upon? We really wanted to focus on like the positives of our working relationships with each other and like our skills that we're trying to build. We wanted to really like use this as an opportunity to like improve our our culture and not like lead to like a lot of nitpicking or anything. Which is why we focused on like three positives and like one thing to improve upon. And again, very open ended questions for people to reply kind of as they wanted. We included A few prompts in our survey. So, like, they could choose to comment on like efficiency or teamwork or communication when they were answering those questions. But those were our objectives of the program. And then the two questions that were going to be in our survey.
- [10:14]
Co-host or Additional Host
That's great. You know, I think I was just so interested in this and such an important topic. You know, I did see though that like you, you conducted this research during the pandemic. What were some of the challenges that you felt like you encountered to complete the task? And do you think that the pandemic could have influenced or skewed that data?
- [10:31]
Laura Erdman
Yeah, I think as I'm sure for many people, Covid feels like a blur. That was both years ago and yesterday. And so I think it's hard to comment on that part. Like, exactly. I, I think it probably had both a negative and a positive impact, if we're being honest. I think in one way people were really stressed, overworked, overwhelmed, and so like, maybe didn't engage to the degree that they would have outside of the pandemic. But I think also there was so much like, appreciation for your colleagues and we all kind of had like, for lack of a better word, like trauma bonding during doing Covid. And I think being able to have a space to kind of share like some accolades for your teammate and like be able to kind of build people up was also like, really amazing. So I think it, it probably had a little bit of both a negative and a positive impact on our, on our data, if we're going to be honest.
- [11:19]
Co-host or Additional Host
Yeah, I totally understand that. Definitely. So I also have a few questions regarding the methods that you used. I understand that you first surveyed a pilot group and your assessment was designed for PAs, MPs and physicians. Why'd you choose to create a pilot first? What area of practice did you gather that feedback on? And were the questions the same for all the clinical roles?
- [11:40]
Alexandra Gallant
Yeah. So we chose to do a pilot first partly because we wanted to make sure like the like, electronics of the thing worked. Like technical glitches.
- [11:51]
Laura Erdman
Yeah.
- [11:52]
Alexandra Gallant
Rule out any technical issues before we like submitted it to like 100 colleagues and got a bunch of emails back. So we did it for a one month pilot with our three medical oncology teams. And again, as I mentioned, our physicians work Tuesday through Monday apps Monday through Friday. So at the end of a four day stretch together, we would submit that peer feedback survey to them to fill out. And then we sat down with everybody who was involved in the pilot and got just kind of informal feedback on it and Overall, people really felt like it was a really positive experience. They really liked giving, like, kudos to their colleagues. They did say the not anonymous part made it a little bit awkward as far as providing, like, critical feedback, but they said still, overall they enjoyed the platform and would use it. So we decided to not really make any changes after the pilot and then submitted it to our whole group. And yes, the questions are the same, whether it's a physician giving feedback to a PA NP or. Or a PINP giving feedback to a physician. And then we rolled it out onto, so our medical oncology team, our hospitalist teams, and our medicine consult teams. And since this whole program started, we've expanded it to all of the other services we've made. But that was kind of like our initial. I love that you kept the questions the same. It really embodies that peer notion of peer feedback. Yeah, we just really wanted it to be, like, bidirectional. It's equal.
- [13:21]
Podcast Host
Yeah.
- [13:21]
Alexandra Gallant
Like, I feel like there's still, you know, some hierarchy obviously between, like, physicians, pamps, and we really don't want that to, like, play a role if we can help it. And so we really wanted it to be the same feedback. Well, I know we all live part of that, you know, the relationship you get as peers, and then also still that innate hierarchy that comes especially in an academic medical center.
- [13:40]
Laura Erdman
I thought one really cool thing about your article is that you did share some of the responses that your team.
- [13:45]
Alexandra Gallant
Gathered and could relate with a lot of them. Tell us about some of the common themes that you received in responses from both the PAs and NPs and physicians. What were some common positive responses and.
- [13:56]
Laura Erdman
What were some areas that you were like, oh, we have a little bit.
- [13:59]
Alexandra Gallant
Of work to do.
- [14:00]
Laura Erdman
Yeah. So after this was live to everyone, to all of the people in innovation, like 100 providers for three months, our amazing teammate Lauren, who helped us publish the paper, he identified all the data for us. And then Lexi and I went through it independently just to kind of write down our own thoughts on, like, what were some themes we saw and then got together to see if we both kind of agreed on common themes. And mostly there was a lot of comments on people's, like, medical knowledge, their efficiency, their communication, their education, teaching, bedside manner, patient advocacy. A lot of the things that we had put as a prompt, people had, like, kind of used to take that and make further comments. But it was interesting to see if there were some clear differences in what EVPs were commentating. Positive comments about versus MDs. And the APV tended to score positively in their areas like medical knowledge and efficiency, as well as their communication and like their bedside manner. And the mds scored positively most interesting in APC advocacy, which was not one of the prompts that we had put in our, in our thing, but it was very common. It was very prevalent throughout the group that people were commenting that the MDs were APV advocates, which I think speaks not only to the culture in our group because we already do have a pretty good culture. But it was nice to see that that was independent of us prompting. But they also, the MD scored well in communication, education, bedside manner and teamwork. So people largely use the prompts we have provided. But the MDs getting a lot of comments on APV advocacy wasn't something that we had necessarily expected to see. And the feedback was largely positive. Over 50% of people said someone didn't have any areas of room for improvement. And I think part of that is the fact that it's not anonymous and you are kind of more tending to say we want to say nice things about your colleague that's maybe harder to give like something more constructive. And I think again part of that might have been Covid times where people are saying like we're already all working hard enough, like let's, let's all just like raise each other up. But there were definitely some constructive comments from people. And I think most often we saw in our group that the ADPs got comments on improving their teaching, bedside teaching and their efficiency and the MDs got comments on efficiency. And I think overall that kind of speaks to like we're all working hard and we all want to try and like do the work in a, in a kind of more efficient way as we can through the day. So it's helpful to have both colleagues working on that. But I think did speak to some interesting trends of like there's probably some areas that we can work on as far as like improving maybe AVPs feeling that they are able to do bedside education. Because I think when you're at an academic institution it's often that kind of like the default is that you allow the MDs do a lot of that education and that APV's kind of just like put the shoulder to the wheel and get the work done. So yeah, it was really interesting like reading through the trends on everything sounds.
- [16:34]
Podcast Host
Like also you guys only positive things came out of this, you know, feedback platform and it's helping the teams. I think other hospital systems should mirror this. So as a follow up I found the results from the feedback platform Insightful, like I was saying. And the differences in the skills that PAs and PEs and physicians value in a teamwork was interestingly quite different. Can you highlight those findings for us?
- [16:59]
Alexandra Gallant
That was kind of like a fun like result that we got. We weren't really expecting. So yeah, we discovered specifically that physicians really appreciate PAs and nurse practitioners who are really thorough but efficient, are really knowledgeable and are like experts at kind of like hospital like complexity. So getting your patients kind of through their hospitalization. And so that's what NPS PAs should like embody to get like the most appreciation from their physicians and then vice versa. Our NP PAS really appreciated physicians who gave them autonomy with like a balance though of like being great team players and like taking on some of that workload. So kind of balancing those two pieces was really important. And then again that app advocacy thing was like another positive that apps really appreciated of their physician colleagues. And I think noticing those trends I think can help us build like stronger workforces. Like if we can onboard and educate and train our apps to be like super efficient, really thorough, like really knowledgeable on the healthcare system, like they're going to be the best assets to our physicians. And if we make, you know, onboard our physicians to be really great team players, really allow their apps autonomy making decisions and really like advocate for their apps, our apps are going to be like most happy in those, in those relationships. So I think it's like just really telling and it's like helpful to I think make and build like better teams between physicians and NPs and PAs. Oh, that's like the perfect build into our next question. You guys were describing some very objective characteristics of PAs and NPs as we grow as professionals and how to be, you know, utilized as optimally as we can on these care teams. We know that, you know, many different health systems have different care models for their NPS and pas. How do you think peer feedback could be utilized at those health systems to help create a team like yours and to really kind of bring everybody up to their fullest potential?
- [19:07]
Laura Erdman
Yeah, I think this kind of feedback like our hope would be that can only improve all team dynamics. Like it definitely I think has improved the culture within our group. We actually presented this data at a grand rounds within our division last year. So the those like a few years after the platform platform had been live at this point just to kind of give people like a state. What's the state of peer feedback? Like what are people getting? And we were presented basically kind of like what we found in our paper to the division so everyone could see, like, what are the themes of feedback people are getting? And I think it was really, like, it really resonated with people to see that, like, ABBs value X, like, ABs value MDs that are ABV advocates and, like, and MBs values who are, like, really efficient and know the hospital system and are going to, like, really, you know, help be a great team player. And so it was, I think, helpful to see, like, the feedback you're getting individually is not just you. Like, everyone appreciates that and, like, kind of helps that or for an md, like, resonate, like, okay, if I'm a better AP advocate, like, I'll be more valued on my team. And so I think it was. It was helpful to, like, present the data to the group so people could see, like, maybe what you're getting individually is not just you, it's everyone as a division is going to work on these things. It also helps kind of say, like, okay, like we were mentioning earlier, like, if a lot of the APs are getting feedback on, like, they could be better bedside educators, and, like, is there a way that we can implement some teaching for the apps within our division to become better bedside educators? And how can that kind of help? And I think being able to show that that's a theme within your group can help build, like, the culture that it's not you in a silo. Like, everyone is. Could work on this part and how can we, like, all kind of move up together? So I think having that feedback available to people just helps kind of build that collaborative culture and bridge that, if that makes sense.
- [20:48]
Alexandra Gallant
Y' all have talked a lot about apps and teachers and educators and growing, like, in that role. And I know that you work in an academic hospital. Do you think that this project would still be valuable to programs that are in community settings?
- [21:01]
Laura Erdman
Yeah, I think, like, our hope and our belief is that is, like, impactful no matter where you're getting it. Right. We realize that our team structure of having, like, the AP md, like, dyad, like that in a team kind of leads to having feedback be more, like, natural or seamless because of just the way we're set up. So in other settings where maybe your care is not as, like, directly overlapped, it might take a little bit more planning or strategy to make that happen. But I think there's still opportunities for that. Even if you're, like, in, say, like, a private practice. If you're in, like, a private practice specialty, and, like, maybe the ND app is, like, share a Patient panel and they kind of trade off. Like the APB sees the patient a few encounters and the ND sees them. I think those are still opportunities. Like maybe it's not direct observation of patient care, but like patients might make a comment about a provider and they saw, or you might read a note and have some feedback on maybe some clinical work that they did based off the documentation that happened for that patient. Or you have mas like nurses, you have other ancillary staff support within your clinic that is directly observing how you interact with patients. And I think that can be utilized for feedback. Even if it's not provider to provider, it's still like a teammate, peer in that sense. And so our hope is that even if the structure isn't look the same as it was in our division, that people can start to utilize like those around them that are working with patients to incorporate feedback into like their clinical growth.
- [22:18]
Co-host or Additional Host
You know, I think it's so important to note that we've talked a lot about team and the team throughout your paper and this discussion. The AAPA has adopted the optimal team practice policy which as they define, occurs when PAS physicians and other healthcare professionals work together to provide quality care without burdensome administrative constraints. This should allow a PA to practice to the full extent of their education, training and experience. So what do you think the take home message here is? How can we use your results to improve clinical practice in a team based care model? Specifically, how is your research important to help the organizations integrate OTP for PAS into their system? What future research do you think is needed for to further address the challenges of working relationships among PAs MPs and physicians?
- [23:12]
Alexandra Gallant
Yeah, I mean I think the take home message here is that people are looking for feedback on their clinical skills. I mean that was like step one of our project was to obtain the buy in and see what the gap was. And everybody pretty much said that they don't feel like they get feedback after training and they wanted feedback, they wanted to hear from their peers, like what they do well, what they could work on. So I think that's like the biggest take home message overall. But I think with this OTP policy that the AAPA is putting in, they're really focusing on like team based care. So when physician pa, NP teams like work closely together, I think we have the ability to create peer feedback platforms kind of more broadly and it's a really underutilized opportunity to be able to achieve kind of clinical excellence or really work at the top of your license. At the beginning of our article we mentioned specifically what clinical excellence is, and it's actually been something studied. And there's nine pillars that make somebody clinically excellent, and those are diagnostic acumen knowledge, scholarly approach to clinical care, skillful navigation of the healthcare system, reputation, communication and interpersonal skills, professionalism and humanism, and passion for clinical medicine. And so our feedback platform, I think, really pulled out a lot of those pieces that lead to making somebody clinically excellent. And creating a program like this at your institution, I think could really help our apps really kind of like excel and become the best clinician that they can be. I think before anybody wanted to integrate this at their institution, Laura kind of talked about, like, looking at your structure and like, where there's overlap and where people could get feedback on their skills. But I think it's also important to make sure that one, like the culture is at your institution is like, in a place where it could accept something like peer feedback, because it is hard, I think, to provide that physician PA feedback sometimes. And you would also want to make sure people, like, know how to give feedback. You know, at an academic institution, that's a big part of our training is how to give feedback to learners. So we already have some of that kind of like, innately in our group of, like, how do you give feedback to a colleague in a way that's going to be, like, beneficial and not hurtful? So you need to think about those things before you'd apply it to your institution. And then, like, for future research for stuff that, like, Laura and I want to do with our peer feedback program is we'd like to see it expanded. Like, we're. We're at a very specific model in our group. We'd like to see other people utilize it and see kind of the results that they get. In addition, we know that we're missing some people in our group. This is mainly our day shifts that are getting this feedback. And so we know people who work nights or swing shifts are kind of missing out on that. But we also just want to see this work be kind of used more broadly and used to help create faculty development programs and things to help us build our skills to become the best clinicians that we can be.
- [26:16]
Laura Erdman
Yeah, I think, interestingly, not that we know that this is any way unrelated, but one of the. Some of the junior APVs within our division actually have started an APV at night where people can go and, like, give a chalk talk informally to the other APV colleagues kind of practice. So they have chalk talks kind of in their repertoire before they're, like, on Rounds for people. And by no means did we prompt this, but we do kind of like, you know, it's interesting. We've been giving this, like, these themes of what came out of this peer feedback. And a lot of it was like, advs being better at bedside. Like educators and some of the younger aps in our group took it upon their, like, upon themselves to like, create these APB heads that are like, low, very informal, like, go hang out with your colleagues, practice the chalk talk. Feel like you have some confidence around rounds. And I think that's really awesome that, that, like, whether this came out of it or not, it's great that people in our group are doing this. But I think hearing that you're not alone, other people have like, this gap kind of helps it normalize that maybe this would be a good idea to like, implement something like this. So it's been really cool even just seeing, like, the conversations that have come out of your feedback. Like, we've talked about, like, should we try to, like, expand this? So, like, patient handoff stuff as far as, like, when you hand off a team, like, do you give feedback, like, to the colleagues that had the team before you? And like, so we're trying to think about, like, what are the next steps on it. But it's been exciting to have a lot of those conversations with our colleagues around, like, where can this kind of expand from here?
- [27:33]
Podcast Host
That's great. And I've learned so much from this article after reading and listening to you guys discussing it. And I think that it's very important to get feedback. There's no way you can improve or, you know, hone your skills if you don't know what you're doing right and what you need to improve on. So you don't know what you don't know. I think feedback is very important and I'm always begging for feedback. I always ask my physicians, don't tell me it's all great or what I'm doing right, but tell me what I need to work on because that's the only way I'm going to get better, because then we remain stagnant. And I'm sure Kim is getting a lot of tips and ideas from you guys to implement in her own hospital esteem because she's also in a leadership role in hospital medicine. So I'm sure she's, she's getting all the ideas.
- [28:20]
Laura Erdman
Yeah, as I like to think, one of the comments on, like, our initial, like, even needs assessment survey was like, at the very least, I just get like, some nice feedback and at the worst, I like, figure out like, what did they say something like, at the worst is that I just hear nice things. And the best is that I find out something constructive I can work on or something to that degree. And it was like, that's let me find the quilt. Because it was so perfect. It was like so perfect.
- [28:41]
Alexandra Gallant
We'll find it.
- [28:42]
Laura Erdman
And we were just like, that perfectly embodies like what we're trying to do here.
- [28:45]
Alexandra Gallant
That's great.
- [28:45]
Podcast Host
And you guys sound very passionate about it and I like it.
- [28:49]
Alexandra Gallant
Yeah.
- [28:49]
Laura Erdman
This one, at the very least, it would be a nice boost in self confidence and likely would result in actual items for self improvement. And I was like, I love that.
- [28:56]
Alexandra Gallant
That's perfect.
- [28:57]
Laura Erdman
Like, you're right. At the very least you're going to get some like, little taps on the shoulder and, and you might find something that you can like constructively work on to like, continue to build yourself clinically.
- [29:07]
Podcast Host
Yeah, there's a win, win situation. I don't see how you're going to lose out. At least you know, because even if you're not told, but it remains, you still lack that skill or you're still not doing well in that, in that, on that side. So it's better to know and you can improve it, actually.
- [29:21]
Laura Erdman
Yeah. And I, I think our hope too is that as people do this, get used to having this structure, especially as people come into our group like from outside institutions and, and kind of realize this is the baseline culture, like that some of this happens a little bit more naturally. Like, I know me, myself, I haven't been very good at filling out the serve like our, filling out our forms anymore that get auto sent to us because I end up just chatting with the attending I'm working with at the end of the week and be like, hey, like, what do you think we did well this week? And like, next time we work together, what should we do differently? And like, it kind of just ends up feeding into that natural conversation that allows you to kind of like make that as, as a dialogue rather than like something you're just like submitting. And, and that's our hope, is that it just becomes kind of more normalized. That's beautiful.
- [29:57]
Alexandra Gallant
Building yourselves, building your team and making it better for patients. That's perfect. And I think one other thing. So Laura mentioned at the very beginning this all resulted from her doing like, her like annual evaluation with our division head. Now we actually have like, concrete, like, things to take to our annual reviews or for us in an academic institution to like, advocate for promotion. Like we, we have like data that we can show people. Like, these are the last 10 like responses I've gotten from my physicians on how I work as like a clinician. Here's the evidence that I'm doing good work. Here's the reason why I should like promote or something like that. And so we didn't have that before. And now you have like information that you'd never had on like your clinical skills to be able to, to show people what you're doing. So thank you guys for showing. As always, please be sure that you're following us on JAPA on social media. That's AAPAonline and let us know your thoughts about the topics we went over today.
- [30:53]
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