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ASQC: Advice and Suggestions to Questions about Career in Neurocritical Care How to Form a Cohesive Team and Give Feedback to Trainees

By Currents Editor posted 11-07-2019 09:26




Christa O’Hana S. Nobleza, MD, MSCI

Assistant Professor

University of Mississippi Medical Center

ASQC_2.jpgAleksandra Yakhkind, MD, MS

Neurocritical Care Fellow

University of Pennsylvania Health System

ASQC_3.jpgGuest Advisor:

Chitra Venkatasubramanian, MBBS, MD, MSc, FNCS

Clinical Professor

Stanford University

Do you have questions regarding your professional life? Is there a conundrum at work that requires an outside perspective?

The Trainee Section and Women in Neurocritical Care (WINCC) Section have teamed up to publish a new column in
Currents to serve your professional advice needs. Submit questions to, and we will get them answered by a seasoned advisor. We believe in life-long learning and mentorship, and this column and our mentorship programs are tools for your professional success. Read on for professional advice by senior WINCC members on forming a cohesive team and giving feedback to trainees. 


I am an attending with four years of experience. Overall, I have a great team of apps, fellows, residents and students. However, every once in a while there is a trainee who does not pull their weight and things get missed. How should I communicate with these trainees and give feedback most effectively? What if they don’t improve after feedback?


Soft Rock 

How should I communicate with these trainees and give feedback most effectively?

  1. Set up expectations for what you want to see from your team right from the get go. For example: Have a huddle for 5-10 minutes, get the team to introduce each other to get a sense of how experienced they are in the neuro ICU world (this will help you adapt your expectations from them) and ask them what they want to accomplish for themselves from the rotation.
  2. Then, you respond to the above and lay out your expectations of what you would like for them to have learnt or done by the end of the rotation. For example, a certain template for presenting, perform a procedure under your supervision, run a family meeting under your supervision, discuss a journal article, etc.
  3. Give them/point them to any educational resources. Teach every day. At the end of a patient encounter, if there is a teachable moment, pause, clearly state that this is a teaching point or a skill, demonstrate/teach and then move on. Mini lectures help as well.
  4. Let them know that you will give feedback throughout the rotation and that they should also ask you for feedback as they need it. This signals your availability to the team.
  5. Feedback daily for a couple minutes while events are fresh, a mid-week check in and end of rotation comprehensive feedback. Never reprimand in front of the rest of the team; however, do pull aside the trainee for quick feedback the same day while the events are fresh. Feedback should be kind, specific and non-judgmental


What if they don’t improve after feedback?

Figure out if the trainee has other personal obstacles that are preventing them from reaching their/your shared goal (fatigue, burn out, sleep deprivation, too many patients, knowledge gap, personal issues, etc.). 

Be frank and ask them in a positive way how you can help them. Make it about “us” not “you.”



Chitra Venkatasubramanian, MBBS, MD, MSc, FNCS

Clinical Professor

Stanford University


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