CEimpact Podcast

Words Matter: Fostering Respect and Avoiding Stigma

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Stigmatizing language may be part of our daily interactions with patients without even realizing it. It can appear in charts, regardless of race, gender, gender identity, ability, or socioeconomic status, but it has been found to occur more frequently for groups who are traditionally marginalized. How often do you reflect on the language you use with patients and how it might be interpreted by them, depending on their unique circumstances? And what are we doing as preceptors to help our residents and students understand the importance of language in their patient interactions? Listen in to learn more.

Host
Kathy Schott, PhD
Vice President, Education & Operations
CEimpact

Guest
Kashelle Lockman, PharmD, MA
Clinical Associate Professor
University of Iowa

Get CE: CLICK HERE TO CPE CREDIT FOR THE COURSE!

CPE Information
 
Learning Objectives
At the end of this course, preceptors will be able to:
1. List examples of stigmatizing language and its impact on pharmacist-patient interactions
2. Describe strategies preceptors can use to foster the use of non-stigmatizing language by students and residents

0.05 CEU/0.5 Hr
UAN: 0107-0000-24-250-H99-P
Initial release date: 8/21/2024
Expiration date: 8/21/2027
Additional CPE details can be found here.

The speakers have no relevant financial relationships with ineligible companies to disclose.

This program has been:
Approved by the Minnesota Board of Pharmacy as education for Minnesota pharmacy preceptors.

Reviewed by the Texas Consortium on Experiential Programs and has been designated as preceptor education and training for Texas preceptors.

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Speaker 1:

Hello. If you are a regular listener, welcome back. If you are new to preceptive practice, then welcome. We're glad you're here. Ce Impact brings you this podcast on the third Wednesday of the month. Each episode engages insightful guests who share resources and ideas to help you improve your precepting practice, become a more effective teacher and mentor and balance your work with these additional but important responsibilities.

Speaker 1:

Stigmatizing language may be part of our daily interactions with patients without even realizing it. It can appear in charts regardless of race, gender, gender identity or socioeconomic status, but it has been found to occur more frequently for groups who are traditionally marginalized. How often do you reflect on the language you use with patients and how it might be interpreted by them, depending on their unique circumstances, and what are we doing as preceptors to help our students and residents understand the importance of language in their patient interactions? Dr Cashel Lockman, a pharmacist and preceptor at the University of Iowa and University of Iowa Hospitals and Clinics, joined me recently for a conversation on what it means to say it nicer when working with patients who may already feel marginalized and how we can foster this important mindset in our learners.

Speaker 1:

Let's listen in Well. Welcome, kishel. It's great to see you today. You know I know you and I have known each other for a long time through our various College of Pharmacy connections and other work that we're doing here in the state of Iowa. But if you would share a little bit about yourself and your background and then why this topic matters to you or has grown to matter to you.

Speaker 2:

Sure, it's great to see you and be here today with you.

Speaker 2:

I always enjoy working with you, so thank you for the invitation to talk about this topic, which I am very passionate about.

Speaker 2:

I am a palliative care pharmacist and I've been in palliative care pharmacy for about 10 years and since my early days as a learner, I remember my preceptors talking to me about how important language is and how the words that we choose can really impact how patients feel that we care for them or don't feel that we care for them, and can impact our relationship with patients.

Speaker 2:

So and I've continued to observe that be the case and I think I'm also a faculty member I was a professor at the University of Iowa College of Pharmacy for eight years and taught palliative care throughout the curriculum and directed our palliative care certificate there, and I saw this continue to be the case. And as an educator, I also see how the words that we use in how we describe and interact with learners can foster our relationships with them or actually sometimes be demeaning and harmful. And so, both from my palliative care lens and from my educator lens, I think this is a huge issue. I'm currently a clinical associate professor at the University of Iowa Carver College of Medicine in the Office of Consultation for Research and Medical Education, and so you know that communication is of the the things that we focus on in our educational efforts in the office I work in.

Speaker 1:

Yeah, yeah, awesome, and I know that's a newer endeavor for you, so I'm really excited to see where that goes. So you touched on this a little bit, cashel. You know how, how language, can you know, shape or impact relationships between the pharmacist, or really any healthcare provider, and the patient? You know, and the impact can be positive or negative or neutral, you know, maybe you know. So can you talk a little bit about how you believe language shapes that perception patients have in the relationship they're having, you know, with their pharmacist or other healthcare provider and you know, what impact does language have on that relationship?

Speaker 2:

a little bit more specifically, and so, first of all, as I mentioned, it can connect us with the people we care for, or it can dehumanize them at medical appointments is seeing how the person that I met a visit with doesn't feel like the team's listening to them or cares about them in the way that they're being spoken to. And then I've also experienced this from patients that I've been part of the care team for, and so, for example, you know, I remember one day in pharmacy we're taught to ask the three prime questions, right, when someone is picking up a prescription and we're going to see what they already know about the medication and how we can fill in the gaps and help them know everything they need to know to use the medication safely and effectively. So one of the three prime questions is what did your doctor tell you? This medication is, for Seems, pretty harmless, right? Right, I mentioned I'm a palliative care pharmacist, and so often the medications that patients I've cared for are picking up are opioids, and there's a lot of stigma and just complexity around opioids.

Speaker 2:

You know, it's throughout our society, in the media, it's on television, it's everywhere. And so patients come with these internalized concerns about opioids before they've ever taken one in their life. And so I remember someone coming back to clinic and being very upset that at the pharmacy they were questioned on why they needed the opioids. And so we said you know, tell us more like what was asked. Like they said what did your doctor tell you this medication is for? As if I don't need it for pain, or you know. And so there's a disconnect sometimes between the jargon that we're using and you know.

Speaker 2:

It seems just like normal words, like totally normal words is what we were taught to do, but that's not how patients are and their caregivers are experiencing the language, and so you know, I think we have to separate like intent and impact here, because we all went into pharmacy and other health professions to care for people and so that's one example a relationship in the education sphere too. So I often see these preceptor development sessions on, you know, dealing with the difficult learner.

Speaker 2:

Okay, first, of all dealing with you know that's just antagonistic language. And then you know, if I think you're a problem learner or a difficult learner, I'm not going to look forward to interacting with you. Right, I also might feel like I don't want to do that or I don't have the skills to help you. It's too hard, it's just, it's a terrible phrase. Right, you, it's too hard, it's just, it's a terrible phrase, and so so I think, like dealing with is just one half of it. That's problematic for me.

Speaker 2:

So we're, we're interacting with.

Speaker 1:

Right, we're working with, we're engaging with.

Speaker 2:

Collaborating with we're. You know, teaching, caring, supporting, and then the difficult learner or the problem learner. I was a difficult learner, okay. So as a former, you know difficult learner or challenging learner. I had a lot of challenges in my personal life during my training and I was probably described as a difficult learner, right?

Speaker 2:

But it is a learner who's having difficulties and challenges and there's a lot of social determinants of learning, like there are social determinants of health, and I think a lot of times we use those labels in both instances, with people who are having significant challenges and need more support and different ways of getting support than we might be used to thinking about.

Speaker 1:

That's such a great example and, you know, I've seen it with patients too. I've seen education around dealing with difficult patients or difficult patient interactions, and it just sets the tone for the wrong kind of you know the wrong kind of interaction. And we've gotten to the point where we know to say, patients with diabetes or patients with X. Why don't we say you know patients with, you know these challenges, or students who are experiencing these challenges, you know, whatever it is, it's, it's the same thing, right, first person language, as opposed to using the describer as if it's a part of their you know, of their person. So, yeah, really interesting.

Speaker 2:

Absolutely.

Speaker 1:

Yeah, other examples that you've, yeah, other examples that you've witnessed. I think this is all just really helpful and it helps put things in context. And you know, and even your first example it's we get into the process of our work, right, these are the questions we ask, these are the tasks we complete, and we don't even think you know really about what, how those questions or how those those you know, the common way we interact with folks on a normal, on a typical interaction, might be perceived depending on what the context of the situation is.

Speaker 2:

Yeah, sure, you know, patients have access to their notes, which is a really good thing, and even before they had access to our notes, we should have been very thoughtful about our language. And now I think there's a bigger impact on the relationship, potentially positively or negative, between patients and their care team based on how we document in our notes. So another thing that I've seen is, you know, in a note a patient read that they presented to clinic for a refill of opioid medications. Yeah, like, think about that how that makes you feel. Why did they come to clinic for opioids? That's kind of negative, especially again in our societal milieu. But they came to clinic because they have severe pain that needed to be managed and we decided that opioids would be a good option potentially to improve their pain.

Speaker 2:

Right, and so they were coming to us for help with their suffering, not for any specific medication.

Speaker 2:

And so I think, like you know, just subtly, and you know the patient gave that feedback and so I think that's important. And then other things I've seen in my practice area and they're they're probably examples in other practice areas as well. You'll hear like the patient failed chemotherapy. Okay, well, that's terrible. I mean, how do you think that's going to make the patient feel even worse? And they're, they have a serious illness. You know chemotherapy was ineffective for the patient. I think we should just take the word failed out of it. But if we're going to use the word failed the chemotherapy failed.

Speaker 1:

The patient right.

Speaker 2:

Right, so so, and these things get documented and read by people we're caring for, and and I'm saying the patient a lot, and that is also one of my pet peeves, and I think that's when we're teaching and in the clinical environment let's use people's names. They're human beings and using their name centers us on them as whole people, um and and not just making them a small little patient, you know so an illness is part of their larger life and all of that is important, and so I think you know not using the word patient in our

Speaker 2:

notes, but using the person's name, not using initials or the word patient. When we're teaching, using cases, this models for learners, you know when we're teaching how we present things and so so, anyway, so those are some of the other things I've seen. I've also seen, you know, the patient refuses X, and I think I've seen that in my own chart as a patient, and you know why. Why did the person not want to do that treatment, like you know, it's just like refuses is very negative.

Speaker 2:

There's always a reason why people are choosing, making the choices that they're making, right, and so maybe they were concerned about an adverse effect that we didn't effectively address for them, and that's fine. Or maybe they couldn't get to the appointment, and so they are. That just doesn't align with what's going on in their life right now. So they're refusing that procedure or whatever it is I don't want to use the word refusing. They're declining that for now or maybe forever, because they they are too worried about it or can't afford it. There's so many reasons. And then the other thing is like adherence and non-adherence. Okay, so I was taught in pharmacy school don't use compliance, use adherence because it's more friendly. But I gotta tell you, I'm also a creative writer, I'm a poet, and so I use the thesaurus a lot.

Speaker 1:

And those are synonyms.

Speaker 2:

Okay, so it doesn't matter if we try and parse out some kinder meaning in the pharmacy or medical professions. It matters what non-medical people view words as, and that doesn't sound good when you read it in the note. And again, there's so many reasons why a person might not be taking the medication that the team recommended. Maybe they never agreed to it to begin with and the team just didn't listen to them. And so in the UK they like to use concordance and non-concordance. So I think that's one strategy. But another strategy is just like say what you mean, say what's going on for the patient. They were worried about this adverse effect, so they stopped taking it. There was a prior authorization and they couldn't get their medication. They actually had some concerns they didn't voice at the first appointment because they didn't feel comfortable.

Speaker 2:

You know, get to the bottom of it and just state the facts like what's really going on. That will help us help our patients more than labeling them with, you know, a nice neat label, and I know a lot of times people think, oh well, we need to do research. Okay, so we don't document just for research, right? Research methods we can use to, you know, get natural language processing. That's beyond my scope, but there are definitely researchers who are are who are looking through qualitative notes and in using AI and different technologies to be able to do that, yeah, and I think you actually will find out more information that way, because non-adherent doesn't tell you a whole lot.

Speaker 1:

Right, right, well, and you're not. You're not just doing this for in case the patient reads it Well, and you're not, you're not just doing this for, in case the patient reads it Well, the, the human, the human being who has a name, um, you're. You're doing it because it also informs other people on the healthcare team. You know, and that you know the other thing, I, you know some personal experience with my, my dad, who has been through a very serious neck cancer. Um, you know, and I can relate to so many things that you're saying.

Speaker 1:

You know, certainly, the fact that he was managed his hands pain with an opioid was very challenging for us, because every healthcare provider we talked to um had a different opinion about how, how, how much, how long, all of those things. And you know, when you're working with 80 year old parents, they immediately assume like guilt or oh my gosh, I'm not doing this right, we have to make a change. And then, all of a sudden, dad would be managing, he'd be in all this pain, and we're like, why, why are we doing this? You know, so I can understand the stigma of all of that, but also you know the number of times we had to repeat his story about. You know why we were doing things this way versus that way, why he was on this medication versus that.

Speaker 1:

And had the story been in the notes, you know, maybe we wouldn't have had to retell the story every time. You know to somebody new and I don't know that, just really. That really registers with me. So you know we're not, you're not doing this just in case the patient reads the notes. Right, they're 80, they weren't reading the notes. I was reading the notes but, but they, you know. But. But had that other providers on the team understood the various nuances of navigating this illness, how much better his experience might've been.

Speaker 2:

Absolutely, and I'm glad you brought that up. Yeah, absolutely, we, that is that has traditionally been. You know, the reason why we chart is to hand off to other healthcare providers, and you know now the patient and their caregivers are part of the team too, and I mean we view it that way and that's good. I think that's a positive development. But, as you mentioned, if the whole story was there, not having to repeat it, would have been really great. So and helpful to you all. So that is one of the frustrations. Thank you for sharing that.

Speaker 2:

I think when we do put that story in the chart, it's important to be complete, it's important to be accurate. But what you mentioned about other healthcare providers feeding it actually reminded me of some of the missteps we can make and how that can negatively impact patient care. So Gadu and colleagues did a study where they evaluated the impact of a biased or neutral chart note on medical students and medical residents, and the note was about a person living with sickle cell anemia and sickle cell pain, and so what they found was that the biased note, the note that had biased language in it, resulted in less positive attitudes towards the patient and the medical residents selected less aggressive treatments for those patients' pain. Careful about the words that we use in our documentation and make sure that we're not accidentally transmitting bias that could impact a patient's care.

Speaker 1:

Do you remember any of the specifics of you know? How did that bias manifest in the written word, in the language?

Speaker 2:

Oh, yeah, so, um, I think that they used. They used phrases about narcotics, so I think they used the word narcotics and there was language around opioids. Let me see.

Speaker 1:

Yeah, and I don't mean to put you on the spot, I just thought maybe it might be helpful to hear a couple of narcotic Narcotic dependent was one of the phrases that was used. Yeah, so clearly biased language.

Speaker 2:

Yeah, yeah, yeah, and you know it's how learners pick up on on things. Right and make us, and they're always learning and we're, we're all always learning right, and so we're all picking that up yep, well, and as their teachers, preceptors, mentors, we're always teaching, whether we think we're teaching or not.

Speaker 1:

Right, yeah, because shell, can you talk about maybe let's, let's start high level with some system level changes that we should maybe be considering as a profession to address the problem. You know, clearly, as with anything, we've come a long way, probably in many of the ways we're doing documentation and communicating with learners and communicating with patients, but you know, like anything else, this is an evolving thing. But you know, like anything else, this is a evolving thing. You know, and I think too I'll backtrack a little bit because I want to call out your, your comments about social determinants of health.

Speaker 1:

You know, as we're I mean, health equity is, you know, identified as maybe the number one problem right in healthcare and as we, you know, continue to to have more conversations around that and and recognizing. You know why patients might not be taking medications, why patients might be not engaging in a certain treatment. You know, whatever that is, you know that that's also changing, I think, how we talk about and with patients or it should be, hopefully it is. So, just just again, at a higher level, some system level changes. You know, we should be considering as a profession that might help us, you know, move further down this road and evolve in a in a positive way when it comes to how we're communicating with and about our patients and their caregivers.

Speaker 2:

Yeah, so I think that I agreed with you. The system has to start at the profession level. And one of the things I think about speaking of narcotic, the word narcotic, from our discussion of that study, that is just so ingrained in the pharmacy profession. And you know, I was recently visiting a hospital that a colleague works at and shadowing them for the day, and we did a tour and it's like oh, here's the narc vault, and we have the narc vault too. And so I I on an individual teach people not to use the word narcotic.

Speaker 2:

I have memes about not using the word narcotic, but it's so hard to get it out of the lexicon on an individual basis. And so I think, on a systems level, like, why are we using a word that the DEA uses to describe, you know, a place where we store medications? Because it I would argue that it is so difficult to keep the language that we use just with pharmacists separate from what we use in front of patients. I always see it leak over. It is just. And so I think that we've got to. We've got to, you know, refuse to use some of the language that the DEA puts out there like red flags, Right, that's what? Because it I think it really comes between the pharmacist and patient relationship. Right, we are healthcare providers, we are not law enforcement.

Speaker 2:

So I think, that's one thing I'd like to see us talking more as a profession about what some of the terms we use and teach learners. We talk a lot about professional identity formation these days and language is part of that.

Speaker 2:

And so the narc fault is one of those things that people are learning and as they're being enculturated to the pharmacy profession, and so that's when I already mentioned like non adherence and adherence, and I think that can come from journals, for example. We can have style guides that critically think about the pharmacy lexicon and decide what we're not going to use, what we're going to ask authors to use instead, and how we're going to frame language in research studies, commentaries, et cetera that are published. I think on the education side, we've got to look at the resources we use in teaching, whether those are published textbooks, and so, you know, starting to have some conversations and thought around our lexicon and being more intentional about it. And then I think you know, community-based participatory research is, you know, a research method that I really like but, I, think we can use some of the components of that, especially, you know, the community aspect, the partnership aspect.

Speaker 2:

So when we do evaluate our language and our lexicon, we shouldn't do it in a vacuum. We should be talking to the people we care for and having representatives from you know patients, caregivers, what, how do they feel about the language?

Speaker 2:

And some of that's been published, and so we, we can look at what's been published, but we can also, you know, have a community advisory board, for example, on these kinds of projects around our language. When I was a fellow and we were looking at barriers to and I'll use the CDC term young men who have sex with men who are HIV positive, barriers to their engagement in care, and we had community advisory board and our community partners, you know, said we don't like the term young men who have sex with men. That is reducing us to a sex act. And so we said well, what term would you like, like what resonates with you and is respectful of who you are in your life? And they said same gender loving men, you know, and so um, so again, like all you have to do is ask and people will tell you.

Speaker 2:

So um, so anyway. So I think that's one thing we can do, and then um on a system like, if you think about health systems, pharmacies, what's coded in the EHR? Or the medication dispensing system, what are the options when? You're categorizing things, so I think all that needs to be looked at as well.

Speaker 1:

Yeah, yeah, forms, forms, absolutely.

Speaker 2:

And like we can make our forms more inclusive. Getting back to that health equity language, Right yeah, great examples.

Speaker 1:

You mentioned. You know community engagement and you know the opportunities to engage with folks who you know, who we might refer to in ways that are less than inviting and welcoming, refer to in ways that are less than inviting and welcoming. What are some other ways that, as healthcare professionals, you know we can keep ourselves informed? I mean this and learn about. You know how language is evolving and how we can, how we can, better communicate with folks. Are there, are there some places or resources that you know just any person you know can can go, or access to just keep themselves learning and growing and changing with regard to language Absolutely.

Speaker 2:

And I would say that, like, our language will continue to evolve and that's a good thing because growth is important for us as human beings. And so I think some people will say like, oh, it's this term, this year, next year will be something else, Right, you can just kind of be dismissive about it. It's like right, Okay. So I think it's it's important to continually reflect on it and how and how the language we use makes people feel. So there are a lot of resources we can use to reflect on and evaluate our current language. So the CDC offers guidance on inclusive communication with a health equity lens and that's freely available on their website. Samhsa also has some resources specifically about language and stigma related to substance use disorders. The Association of American Medical Colleges developed a health equity guide and it includes a really nice section on language to foster and promote health equity. It offers, you know, guidance on first person language as well which you mentioned before.

Speaker 2:

I love the Hospice and Palliative Nurses Association. Diversity, equity, inclusion and Belonging Style Guide and belonging is one of my favorite words.

Speaker 1:

And to me.

Speaker 2:

That's what our whole conversation is about.

Speaker 2:

Kathy. It's like making people feel like they belong, and I think it's really useful. It's freely available. You don't have to be an HPNA member to access it. The American Psychological Association has an inclusive language guide that has some nice recommendations around psychological illness, as well as some equity-based language in terms of gender and things like that other identities like that and then NIH has a style guide and the National Center on Disability and Journalism has a disability language style guide, and the AP has a style guide too, which they have updated to be in line with some of these other resources.

Speaker 1:

I've noticed which is nice.

Speaker 2:

But the thing is that, like all these resources aren't capturing how medicines and pharmacies lexicon can belittle and dehumanize the people we care for. So some of the things we mentioned earlier aren't going to be in there style guidelines, for example.

Speaker 2:

So I think we need to look back. Just take a minute to reflect on ourselves before we were acculturated to the pharmacy profession and learned all the jargon and the lexicon. How would we feel if we read something like the patient denies constipation in our chart? Honestly, I think I would say huh, they don't believe.

Speaker 1:

I'm not constipated what did I need to do to be more convincing?

Speaker 2:

Okay, and I use constipation, but I often see this with substance histories, which has a lot more stigma. So you'll see, patient denies alcohol use. And yeah, and you might think I'm just being ridiculous, but studies that ask patients about their perceptions of this type of language in their notes actually reflect my own feelings on the matter. So imagine you come to me taking immediate release oxycodone as needed for your pain and I can ask you how many tablets are you using a day, kathy? Or I can ask you how many tablets are you needing in a day, kathy? It's like okay right.

Speaker 1:

This is what one of my totally different pair preceptors taught me.

Speaker 2:

Yes, yeah, totally so it makes it lands totally different. Yeah, one word difference.

Speaker 2:

Yeah, you know, and I can say to you that I believe you have pain. I believe your pain, I believe you need relief from it, and that's what you're using this medicine for to try to get, and all it requires is some thought. That word choice was completely free. It didn't cost me anything but a little thought and time, and so these profession-wide and system-wide changes that we talked about could cost some money, but on an individual basis. The personal changes we make in our language is a free, budget neutral intervention to convey compassion.

Speaker 1:

Right, right, and it's really just getting on the other side of the conversation and thinking about how you would feel, right, yeah, yes, yeah, Well, it might be, it might feel obvious. You know what we can do as, as preceptors, you know in this space, but maybe let's just wrap up with a couple of strategies that you know as preceptors. You know obviously there's. You know we can reflect, we can read, we can research, you know we can work to build our own practice in a better way. But what can we do with students? You know, obviously we need to model these things, but, you know, getting feedback on some of these things might be a little bit more challenging. So, you know, maybe talk a little bit about how can we be intentional about incorporating, you know, this different way of looking at language into our precepting practice.

Speaker 2:

Sure, I think that you mentioned modeling. That's hugely important if you are in a practice where you're using note templates and documentation, going through and updating those so that the language that's used in the template reflects what you're trying to teach learners, and when you go over the template, talk to them about what it said before and how you changed it.

Speaker 2:

I think when you give feedback, having community we already talk about communication skills, probably when we give feedback right. Community. We already talk about communication skills, probably when we give feedback right, but adding this piece of the communication. So in that, if you do Friday feedback I love Friday feedback you tell them out front, like one of the things I want to help you work on is person centered, person first language that you know promotes inclusivity and belonging and fosters, you know, a healthy relationship between you and the patient, and so I'm going to give you feedback on that every week and talk to them about some of your missteps.

Speaker 2:

I mean a lot of things I've talked about in this, in this podcast. You know I've done them before. You know I've learned when you, as Maya Angelou says, when you know better, do better, exactly, and so that's what I strive for and talking about students with that you know mindset and helping them develop that mindset. You know I remember when Hunter Biden was interviewed by Amy Robach on ABC News in 2019, and he said can you say it nicer? And I have a pen on my bag that says say it nicer.

Speaker 2:

Say it nicer so just you know, saying like we're going to talk about how we can say things nicer, how can we reframe these things, and I think the best way to do that is, you know, one-on-one with the learner. In that Friday feedback session, I do think, like as a team, because your team, you might be working on this and your interprofessional team or your pharmacy team other members of the team might not be there yet and so having this conversation with your team will help your learner, because if there's some disconnect there, you're going to be teaching one thing and they're going to be hearing other things modeled.

Speaker 2:

And so we talked about this on my own team and I'm lucky like we have chaplains on our palliative care team and social workers and music therapists. So our chaplain came up with this thing we could do. You just say ouch. And so we went over some scripts that we can use in real time If we hear someone saying something that is upsetting to us and some of this, you know, it's microaggressions, like some of this language. So, for example, if you, if you hear someone say, oh, this patient's like really difficult or really a problem, you know you can say I know you mean well, but can I share how that makes me feel or why you know I worry when we use that? What do you mean by that? Can we say what we really mean and you can even reframe it yourself. It seems like they have a lot of challenges and I know we want to help them. Can we talk about how to do that? Um, so, asking a question or rephrasing, and we just talked about on our team.

Speaker 2:

We'll just say out when we hear things like that and then we know it's going to be a learning opportunity and we're just going to go for it and go there, and it's to help us care for each other and our patients better.

Speaker 1:

Yeah, yeah, I love that. And you know, like you said, we can, we can, you know we can change how we're communicating or, you know, be more reflective about how we're communicating. But if the team in which the student is learning isn't all on that same page, you know there's just going to continue to be disconnect. So I hadn't thought about that, but I appreciate you bringing the team into the conversation, that we have a responsibility beyond ourselves in our own learning. So, yeah, love that. This has been as great a conversation as I expected it would be, so I'm so grateful, michelle. It's given me a lot of things to think about. Even myself, and hopefully listeners as well, have picked up some ideas for how they can reflect in this space and also change, maybe, how they're interacting with students and mentoring students going forward. I'm going to want to get my hands on some of the links to the resources that you mentioned and so I'll put those in the show notes and share that with listeners as well.

Speaker 1:

So I don't know. One final takeaway from you like what's the one thing a preceptor can start doing today to make a difference in how they interact with patients and how their students see them interact with patients?

Speaker 2:

I think the one thing is pausing and reflecting on this aspect of your practice, your verbal communication and your written communication. So next time you go in and see a patient, pause after and think about it. At the end of the day today, or your next day seeing patients caring for patients, regardless of your setting, think about it. So I think it just starts with pausing and reflecting and going from there.

Speaker 1:

Yep, yep, yep, excellent. Um well, thank you very much. This was a great conversation and I always enjoy chatting with you. I always feel like I learned something when I chat with you, so I really appreciate it.

Speaker 2:

Thank you, I enjoyed talking with you as usual and um until next time.

Speaker 1:

Until next time as usual and until next time. Until next time. If you'd like more education on this or related topics, check out the show notes for some links to past episodes and courses from the Preceptor by Design catalog. I've also included links to the resources Dr Lockman shared during our conversation. These might be great readings for both you and your learners and it might create some opportunities for discussion and feedback. As always, be sure to check out the full library of Preceptor by Design courses available for preceptors on the CE Impact website and be sure to ask your experiential program director or residency program director if you are a member, so that you can access it all for free. If you do have access, thank your program director and be sure to log on to CE Impact and claim your CE for this episode. Thanks again for listening and I'll see you next time on Preceptor Practice.