The protocol-driven aspect of the mnemonic refers to ALEEN, a method developed by Peter Pronovost, MD, to respectfully communicate with upset patients. It stands for Anticipate their anger and do not take it personally, Listen without interrupting, Empathize with what they are saying, Explain what happened and why, and Negotiate a way forward. We use this same protocol to communicate respectfully with distressed residents. If a resident is upset about a program director's decision, being heard and receiving an empathetic response can help even if the decision does not change. Individualized refers to one-on-one check-ins between residency leadership and residents at least once a month to ensure they are feeling well and supported, and to hear concerns they want to share. The last piece of the mnemonic is Defend. When a resident concern is brought to residency leadership, we avoid reactionary judgments. We ask the resident for his or her perspective and see ourselves as an advocate, willing to defend the resident if needed. If we determine resident wrongdoing, we approach our intervention from the framework of being an advocate for their greater goals-to help them build a reputation for the success they want to have.
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