After a shift, we often review the day’s case with our learners. We sometimes ask them to self-reflect.

I often used Demian’s ‘Plus/Delta’ approach and ask ‘What did you like /what would you change?’

This approach works well mostly. But, when the answer is ‘I don’t think I would change anything’, it is hard to target teaching and feedback to the learner’s need.

Trick of the Trade: What case did you like the least?

Recently, I started asking this question, ‘What case did you like the least?’

I like it since the learner now clarifies their learning need. This sets the stage for a meaningful exchange suited to the specific learner. This ties in with the coaching theme that was reviewed previously.

Sometimes the answer would not be what I expected at all. For example, a star internal medicine resident expressed hesitancy about suturing, and an excellent emergency medicine resident wanted more independence. Without this probing question, I might not have picked up on those needs.

What other ways do you coax learning needs?

Stella Yiu, MD

Stella Yiu, MD

ALiEM Blog Contributor
Assistant Professor, University of Ottawa Staff Physician, The Ottawa Hospital
Stella Yiu, MD


Emergency physician and clinician educator in Ottawa, Canada. Own opinions. Go #FOAMed!