EXERCISE 11.1: Challenging Training Situations

PurposeFor each of the cases listed, please consider various ways that you might respond as a trainer. These exercises are meant to build your skill and adaptability to difficult clinical, behavioral, ethical, and clinic flow issues in training.

  1. A somewhat new trainee continues to dilate beyond appropriate size, appears overconfident, and demonstrates little “sixth sense” when things don’t feel right. In this moment the trainee suddenly has a look of discomfort, and mentions “I felt some obstruction and a tearing feeling.” See Teaching Points
  2. A trainee is lacking in enthusiasm, often anxious to leave, and is more interested in gaining procedural skills than providing options counseling or empathic care. They tend to sit back and avoid saying much, making assessment of skill difficult. See Teaching Points
  3. You start off with the values clarification exercises with a trainee who is shy but friendly. After a brief introduction, they tell you that they are struggling over whether or not to provide abortions. They feel it is hard to “help someone commit a sin.” They would feel better if only they could spend a lot of time with each patient to make sure that they thought abortion was the right decision for that patient. They especially wanted to avoid doing abortions for those who use it as birth control. The trainee states, “Clearly some patients make bad decisions for themselves, so I cannot trust that they are making the right decision about this.” See Teaching Points
  4. A trainee shows confidence with the procedural aspects of aspiration abortion, but tends to be very formal with clients, using extensive medical jargon, and speaking in a tone you feel is not very empowering to the patients. See Teaching Points
  5. The last couple days in your training clinic, you’ve noticed the clinic flow seems to be less than optimal, with longer patient waiting times, and your staff becoming mildly inpatient with training. How might you approach this problem? See Teaching Points
  6. You are assisting a trainee in a procedure on a patient with a very low pain threshold. During the dilation, the patient starts fidgeting and becomes noisier. The patient then becomes more active on the table, withdrawing from each cervical dilation by the trainee, and starts crying loudly in the middle of the dilation. How do you proceed? See Teaching Points


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