Recently I was teaching the registrars the procedure to inject botulinum toxin injections safely to spastic muscles. Botulinum toxin is the most potent toxin known to humanity and doses for each individual muscle are different. It is very important that the registrars learn about these. Botulinum toxin comes in a powdered form in a vial and has to be diluted before injection. Once diluted the injector needs to work out the number of units in the diluted volume and then decide how much volume needs injecting into each muscle. I had identified in the group that one of the registrars was new and I wanted to help her figure out the dose for a particular muscle herself with me taking her through each step. I, therefore, asked questions to stimulate her thinking and develop a systematic approach to reach the desired dose. The particular registrar felt uncomfortable by this and left the teaching session in the middle. I arranged a meeting with her after the session and she stated that she was not feeling comfortable with the repeated questions asked and apologized about her behaviour. I asked her to give me feedback for the teaching session and she indicated that my questions were appropriate but as she was not able to think and work through the dose, she felt very embarrassed in front of the patient. When I explored this further it turned out that she was having problems at home and was not able to concentrate during the teaching session. I arranged one to one teaching session for her and found her up to the mark in the next clinic. This made me think whether my style of asking direct questions in front of the patient was not appropriate in that situation. However, reflecting upon this I think that instead of asking direct questions I should have helped her solve the dilution and dose problem. Since this teaching session, I have now prepared a formal teaching session with slides and handouts for my registrars. I would
Recently I was teaching the registrars the procedure to inject botulinum toxin injections safely to spastic muscles. Botulinum toxin is the most potent toxin known to humanity and doses for each individual muscle are different. It is very important that the registrars learn about these. Botulinum toxin comes in a powdered form in a vial and has to be diluted before injection. Once diluted the injector needs to work out the number of units in the diluted volume and then decide how much volume needs injecting into each muscle. I had identified in the group that one of the registrars was new and I wanted to help her figure out the dose for a particular muscle herself with me taking her through each step. I, therefore, asked questions to stimulate her thinking and develop a systematic approach to reach the desired dose. The particular registrar felt uncomfortable by this and left the teaching session in the middle. I arranged a meeting with her after the session and she stated that she was not feeling comfortable with the repeated questions asked and apologized about her behaviour. I asked her to give me feedback for the teaching session and she indicated that my questions were appropriate but as she was not able to think and work through the dose, she felt very embarrassed in front of the patient. When I explored this further it turned out that she was having problems at home and was not able to concentrate during the teaching session. I arranged one to one teaching session for her and found her up to the mark in the next clinic. This made me think whether my style of asking direct questions in front of the patient was not appropriate in that situation. However, reflecting upon this I think that instead of asking direct questions I should have helped her solve the dilution and dose problem. Since this teaching session, I have now prepared a formal teaching session with slides and handouts for my registrars. I would