Practical ways to start difficult conversations

If you have concerns about a student's performance or behaviour, then you should contact the university placement coordinator to discuss your concerns, understand your role and expectations (for example documentation that may be required), and clarify the additional assistance that can be negotiated for both you and the student.

How you can prepare for the conversation

Reflect on the current situation and the conversation ahead. Ask yourself these questions, and determine what actions you might need to take before speaking with the student:

• Does the placement provide a culture of quality (quality relationships, quality learning and best practice)?
• Am I providing effective supervision?  You may like to consider some of the supervisor evaluation and reflection tools to answer this question.
• Have you made any assumptions about the student and/or their performance?
• Is the placement providing the student with learning opportunities in a supportive environment?
• Is there effective communication and collaboration between students, the university and placement site?
• Are there adequate resources and facilities to conduct placement activities?

Before the conversation

It is important that you spend some time planning the conversation.  You might find it useful to ask yourself the following questions:

• Why do you want to have this conversation?  What is the purpose?  Is this purpose supportive for the student? 
• What do you want to achieve?  What is an ideal outcome?  Is this ideal realistic or suitable for the student/setting/supervision?
• Is your mindset positive?  Will there be positive outcomes from the conversation even though it is difficult?
• Is the student aware that there is a problem?  How will they perceive it?
• Do you think that third party support from the university will help you clarify the issue and be objective?

Seek advice from your university coordinator to identify and complete any documentation required for the conversation.  Ensure that you have all documents that are relevant (for example, competency or assessment forms)
 
Choose a time and place where you will both feel comfortable and will not be rushed or interrupted. Allow time for the student to prepare for the conversation if required.  The university coordinator may be able to provide the student with tools or templates to help them prepare. 

Consider the room layout and positioning – sitting next to someone is less confronting than sitting opposite someone.

Plan what you are going to say by writing down the key points you need to cover.  Think about what information you want to get from the student and write questions that will help you gather that information.  You may find it useful to review the following resources prior to the conversation:

•  Effective Relationships
•  Questioning Techniques
•  Providing feedback

The actual conversation

Remember that you don’t actually need to talk that much during a difficult conversation. If you use neutral and supportive questions that are task related, you can focus on listening, observing and gathering as much information from the student as possible.  The student will also feel that they are being heard, and in turn will be more likely to then hear you.

Here are some practical tips for starting your conversation:

• Begin the conversation by explaining the purpose of the meeting and the problem you are discussing and seeking to resolve.
• Start your sentences with ‘I’. This helps reinforce that it is your perspective and that it is ok if people have different perspectives.  First describe the behaviour or the problem, then explain the feelings or thoughts it leads to, and the outcomes that result.  For example:
  • ‘When I observe you….I feel like you might need to spend more time on….as it impacts on the outcomes with the client in this way…. ‘ 
• Some other ‘I’ questions you might find useful in initiating conversation include:
  • I would like to discuss…with you as I think it will help us work together more effectively
  • I’d like to talk about how that client interacted with you, but I’d like to get your point of view first…
  • I think that we may have different expectations about how your workload should be managed, and I’d really like to get your thoughts on this…
  • I’d like to see if we’re on the same page with respect to ….  I want to hear your thoughts, and I’d like to share mine as well.
• Once you have employed active listening techniques to gather the student’s perspective, you may need to use probing questions to assist the student think through their response more thoroughly, while also ensuring that you understand their perspective and thoughts.  Some examples might include:
  • Can you be more specific?
  • What makes you think that?
  • How do you see it?
  • How might other people see this?
  • In what ways is that relevant?
  • What is going on in this problem or situation?
  • Do you think we both have the entire picture?
  • Is this situation like something that you have experienced in the past?
  • What do you think are the best ways to manage this situation?
• Once you have started the conversation and have gathered the information you require from the student, it is important that you then explain to the student what you have understood from them, and provide the student with an opportunity to correct you if they feel that their views have been misrepresented:
  • I want to make sure I understand you….
• You may then need to share your perspectives in relation to their views.  Give specific examples and refer to client sessions, documentation, and other interactions. For example:
  • From what you have told me, I can see why you have that view.  I want to let you know how I see it, and then we can see where we go from there…
• If you notice that the student is getting upset or frustrated, acknowledge this using ‘I’ statements, for example:
  • I can see that this has been frustrating for you’
• It’s important to then collaboratively identify solutions or plan the future direction.  Suggest how to move forward and resolve the situation, rather than making demands, and be sure to ask the student to make suggestions that contribute to a positive outcome.  Use phrases like:
  • ‘I’d prefer’
  • ‘I think’
  • ‘I wonder whether’
• You then need to finalise the conversation.  Write down the action points, dates and next steps and seek agreement with the student and university coordinator (if present). For example
  •  'How do you feel about that?'
  • 'How does that sound to you?'
• Close the conversation by thanking the student for their input.  For example:
  • 'I want to thank you for being open to this and for taking this feedback on board'.

References:

Please Note: References remain valid until superseded by later research. The resources referenced here are regularly reviewed and are considered current and relevant to the topics presented.

• Siggins Miller Consultants (2012). Promoting quality in clinical placements: Literature review and national stakeholder consultation. Adelaide: Health
• Occupational Therapy Practice Education Collaborative-Queensland (OTPEC-Q) (2018). Working through challenges on placement Retrieved from: https://otpecq.group.uq.edu.au/education-placements/working-through-challenges-placement/when-concerns-exist-0
• Occupational Therapy Practice Education Collaborative-Queensland (OTPEC-Q) (2018). When the student is struggling Retrieved from:  https://otpecq.group.uq.edu.au/education-placements/working-through-challenges-placement/struggling-student
• Harvard Business review (2017) How to have difficult conversations when you don’t like conflict.  Retrieved November 2021 from:  https://hbr.org/2017/05/how-to-have-difficult-conversations-when-you-dont-like-conflict
• Ringer, J (nd) We Have to Talk: A Step-By-Step Checklist for Difficult Conversations.  Retrieved November 2021 from: https://www.judyringer.com/resources/articles/we-have-to-talk-a-stepbystep-checklist-for-difficult-conversations.php
• Williams, B., King, C., & Edlington, T. (2016). Overcoming difficult conversations in clinical supervision. Journal of healthcare leadership, 8, 31–40. https://doi.org/10.2147/JHL.S96592
• Australian Government – Fairwork Ombudsmen (nd) Manager’s guide to difficult conversations in the workplace.  Retrieved November 2021 from:  https://www.fairwork.gov.au/sites/default/files/migration/712/managers-guide-to-difficult-conversations-in-the-workplace.pdf