" What Do I Do? " Discussing Difficult, Realistic Scenarios and the General Competencies during New Housestaff Orientation

Publication ID Published Version
797 April 22, 2008 1


A focused, 2.5 hour interactive session was explicitly designed to orient new Housestaff to the six General Competencies and address key topics related to Risk Management and DNR (Do-Not-Resuscitate) orders. In small, facilitated groups, Housestaff review and discuss a set of scenarios, focused on difficult situations for new interns/fellows, answering questions on how to respond to the situation, what resources are available, and how the General Competencies relate to the situation. Trained facilitators (Residency Program Directors, Associate Program Directors or Faculty) guided discussions in small, six-person groups within their own classroom of Housestaff. Each facilitator monitors one classroom of up to 24 Housestaff. In the small groups, Housestaff read a scenario about an intern who must respond in a difficult situation. Housestaff then answered questions about the scenario including what they should do if they were the intern, what resources are available, and how/where the General Competencies appear in this situation. After small groups discussed a scenario, facilitators led a discussion with the large group (whole classroom) about the answers to the scenario questions. Materials for this session include a detailed instructor's guide, discussion scenarios and questions (two versions - one for learners and one for facilitators with discussion points for each question), evaluation form and pre-post multiple choice examinations.


Gleason Heffron M, Larson D, Derse A, Frank M, Sheth B, Simpson D, Connelly B, Chan C, Kochar M. " What Do I Do? " Discussing Difficult, Realistic Scenarios and the General Competencies during New Housestaff Orientation. MedEdPORTAL Publications; 2008. Available from: https://www.mededportal.org/publication/797   http://dx.doi.org/10.15766/mep_2374-8265.797

Educational Objectives

  1. To be able to apply the six General Competencies in the scenarios discussed and in their own practice.
  2. To be able to reason through/solve problems similar to the difficult situations or dilemmas presented in the scenarios.
  3. To be able to collaborate with others to solve clinically relevant problems.
  4. To be able to confront fears regarding call assignments, handling other people's patients, and making tough decisions during the first few days on the job.
  5. To be able to apply ethical principles and requirements (e.g., MCWAH policies, WI law) to clinical situations.
  6. To be able to utilize system resources when needed (SBP).


  • Group Discussions, Orientation of Housestaff, Scenario-based Discussions, Decision Making (MeSH), Risk Management (MeSH), Resuscitation Orders (MeSH)


  • Interpersonal & Communication Skills
  • Knowledge for Practice
  • Patient Care
  • Personal & Professional Development
  • Practice-based Learning & Improvement
  • Professionalism
  • Systems-based Practice

Professional Interest

  • Communication Skills
  • Curriculum Development/Evaluation
  • Instructional Materials/Methods
  • Medical Ethics
  • Quality Improvement

Instructional Methods

  • Case-based Instruction/Learning
  • Independent Learning
  • Problem-based Learning (PBL)

Academic Focus

  • Clinical Sciences
    • Clinical Skills/Doctoring

Intended Audience

  • Professional School Post-Graduate Training
    • Fellow
    • Resident


  • Presentation

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ISSN 2374-8265