Reflective Practice and Leadership in Medicine and Medical Education Example Challenges

How do you gain trust with a family you don’t know and deliver catastrophic information?
What are our obligations as we obtain informed consent? The process can seem cruel.
How do you break devastating news (e.g., relapse and terminal condition), be there for them, and not let it get to you?
How do you make the transition from curative to palliative care?
The father wants to do everything, the mother doesn’t – she (patient) is going to die and it’s not going to be pretty. How do I handle this conflict in the family?
What if the family takes the stance that they will only work with certain providers?
(1st meeting of the academic year) Does anyone else feel stupid?

I’ve never done any basic research – how do you choose projects? …how do you know what to bet on?
The first year was demanding – but rewarding, but now I am going into the lab and I know less than the technicians. How do you make this transition from being a clinician to a researcher?
What do you do when your research project is stalled and your mentor appears unconcerned?
I don’t think I’m cut out for basic science. If I don’t pursue this, can I still have a worthwhile career in academic medicine?
Should we tell families we get money from NCI for enrolling patients?

We have discussed how to manage night call. How can we bring these issues forward in the program?
It was suggested to me that I bring up the issue that the transplant team has outgrown the one-fellow position. How do you negotiate change from a position of less power?
How do you judge and respond to behavior of colleagues that you consider to be, if not strictly unprofessional, unhelpful for the organization and/or morale? Also – how does one address such issues from a position of relatively lower authority?

We don’t really hear about how our respective families are reacting to our work. How is this work affecting our families?
...It’s hard to keep a perspective on ...your life. Like, how could my child’s piano recital compare to a child who might die?
Do you attend the funerals of patients? ...What are the implications?
How do we deal with a family who puts excessive demands on us – a family who expects you to be there all the time?
How do you manage the impact of grief on yourself (as a provider) and on your family?

Image credit: Winslow Homer – The Signal of Distress Credit: The Art Renewal Center

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