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What if I fail?
What if I can’t establish rapport?
What if my clients can tell I don’t know what I’m doing?

Do these questions sound familiar? For students facing the challenges of their clinical rotations, these and other fears can undermine what can be a rewarding and fulfilling experience. Learn to master your fears and insecurities using the simple techniques described in this book. Based on the latest advances in neuroscience, The Clinical Success Formula offers a practical approach for remaining clear, focused, and confident, enabling you to pass with flying colors while building a solid foundation for becoming an extraordinary healthcare professional.

“Dan Eisner’s Clinical Success Formula is needed medicine in this era of standardized and protocol-driven health care. Traditional healthcare education programs leave many students feeling overwhelmed with stress, while primarily teaching methods of care that treat the “patient,” not the actual needs of the whole person. Dan’s book lays out a very pragmatic and sensible way for practitioners of all types to view their mission differently, with results I think will be beneficial for all. This is a book useful not only for those in training, but also for everyone who wants to make a greater difference in the lives of the people they serve.”

—Andy Lazris, MD, author of Curing Medicare and co-author of Interpreting Health Benefits and Risks: A Practical Guide to Facilitate Doctor-Patient Communication.


If you are like most aspiring healthcare professionals, the thought of “What if I fail my clinical?” probably crosses your mind way too often. If you are feeling ashamed about this, then here is what you have to do: STOP IT!

Stop it?

Yes. Stop feeling ashamed about the fear of failing. It is a legitimate concern. You have spent an enormous amount of time, energy, and money educating yourself to become a licensed professional. The reality is that you cannot graduate and set off on your career if you don’t pass your clinical rotations.

So, how could you not be scared of failing?

Ironically, I highly doubt that fear causes many students to fail. But fear can be damaging in a different way. An occupational therapy student once told me, “I was so scared of failing my first clinical that I didn’t do a very good job. I got through it, but it wasn’t easy.”

She passed. But was she really “successful”?

Many students equate not failing with success. But that’s a very limited definition that leads professionals to a less than optimal performance.

I define clinical success this way:

Clinical success means completing the requirements in an emotionally balanced state while feeling great about yourself and about the difference you are making in the lives of the people you serve.

Fear that is not managed properly will definitely prevent true clinical success. Yet fear is completely normal, and even healthy, when it is accepted and properly channeled into preparing for any “scary” endeavor.

Several years ago, I supervised an outstanding OT student. She was smart, but

open-minded. She asked questions and accepted feedback well and didn’t expect

her hand to be held. She was also very creative and not afraid to experiment with

innovative ways of providing care. She was a delightful person. In fact, we hired her

after she graduated.

During her 12-week clinical rotation, she posed a fun question of the day to our

staff during lunches. One day, the question was, “What’s something about yourself

that you want to improve?” I was shocked to hear her answer, “I’d like to have better self-esteem.” I thought, How could she not have high self-esteem? She was a “rock star” of a student.

As you already know, the only thing that ultimately matters is how we feel about

ourselves. The great things we accomplish in life (like this student had) really have

very little internal value (i.e., they don’t raise self-esteem) when we lose sight of our

deepest intentions. She was having an amazing impact on the people around her,

yet she still didn’t feel good about herself. I don’t know about you, but I can relate to

this experience.The last piece of advice I offered her was, “You are already awesome. Please

understand that you don’t have to prove that to yourself or anyone. You do the things

that you do because you are already great, not so that you can be great someday in

the future.”This subtle distinction makes all the difference in the world, and is an important

reminder of the power of intention.

When I was a student, I was convinced that I should know everything before I started. This didn’t make any sense, but I wasn’t very logical at the time. I was worried about failing, and I wasn’t alone in this respect.

I once heard a story about the Dalai Lama’s response when he was asked a serious question. He replied with, “I don’t know,” in a lighthearted way, which elicited a palpable sense of relief in the audience.

The audience felt relief because many of them unconsciously felt pressured to know everything. When the Dalai Lama admitted to not knowing something, he gave everyone else permission to be okay with not knowing everything as well, at least for that moment.

I believe the pressure to “know” is particularly prevalent in healthcare. We are seen as the experts who are supposed to have all the answers. The people we serve have high expectations, and if you’re like me, you probably don’t want to disappoint them.

However, when we don’t have the courage to admit (to ourselves especially) that we don’t have all the answers, we forfeit our ability to access new information. The more we get comfortable operating from a place of “I don’t know, but I am willing to learn,” the more we can access our greatest intelligence—our intuition.

This is exactly what happens when we are providing treatment “in the zone.” We are outside the box, immersed in the present moment, accessing the most creative and innovative ways of providing healthcare.

As a student, no one expects you to know everything, and I’d encourage you to relish this fact. Do your best to operate from a place of “I don’t know, but I am excited to learn.” I promise you, maintaining this attitude will help you relax, making the process of learning much easier.

I recently worked with George, a very anxious young man, who could barely sit still and make eye contact. He’d been on the unit for a couple of weeks. While he was generally cooperative, he was easily frustrated by other people and had difficulty being around them.

During the course of our session, I noticed a dramatic shift in the level of George’s anxiety, which, he told me, decreased from a 10 to a 5. A number of ideas that I put forward seemed to resonate with him. The concept of Open-Focus Attention was most helpful.

My colleagues (who worked with him on the unit) reported several positive behavioral changes the next day, including an increased ability to tolerate being around people, and the fact that he seemed less anxious.

One of my colleagues reported that a number of things helped create this dramatic shift in George’s behavior. I wanted to ask George directly if he could specify what he found most helpful.

The more conscious he is about what is really working for him, the more likely he can repeat the behavior in the future. Also, I like to get feedback so that I know what treatment(s) are most effective.

When I asked George, without any hesitation, and even a little excitement, he started telling me how practicing Open Focus was making a “night and day” difference.

He was able to articulate how it was working for him, stating, “I’m not just zooming in on the anxiety cloud, so I am able to relax more and question where it might be coming from, instead of automatically going into panic mode.” In other words, George was empowered by knowing exactly how to manage his anxiety.

Emotional Awareness is the backdrop to the popular concept of Emotional Intelligence, since it is awareness that enables us to be intelligent about our emotions. Awareness is a state of knowing; it has little to do with thinking or analysis.

The story about the young woman who apologized to her friend is a good example. She did not think about or analyze her decision, it happened automatically. This was only possible because she first became more emotionally aware, which naturally resulted in her choosing an emotionally intelligent action.

Unconscious thinking and behavior create the majority of our problems, which is why history tends to repeat itself. Emotional Awareness makes it possible to “change history” by rising above our conditioned habits and to think in innovative, emotionally intelligent ways that produce optimal results.

Emotional Awareness is not about learning new information. It is about tuning into your intuition. Deep down, you already know everything you need to know about Emotional Awareness. However, the following six reminders and accompanying diagrams will help you tap into your wisdom more consistently.

Internal Level Assessment: “I’m feeling really scared right now, because I don’t know what I’m doing. My clients are going to know that I’m clueless. I might even fail! I know I’ll probably be fine, but it doesn’t feel that way. I’m just not feeling very confident.

I have to remember, though, that these feelings are normal. Everyone experiences something like this. I must remember to allow these feelings to be—resisting them only makes them stronger. Besides, I’m not supposed to know everything. It’s unreasonable to expect to be perfect from the start. What can I do right now to prepare myself to perform at my best?”

Internal Level Actions: “I know self-reflection like this makes me more relaxed and focused. Specifically, reviewing my deepest intentions also helps a great deal, so I am going to do that as much as possible. I also know that simply breathing properly keeps my body relaxed and out of a fight-or-flight mode.”

External Level Assessment/Actions: “First, I’ll keep my Deepest Intention list all over the place (phone, car, fridge, bathroom, etc.). I’ll keep up my self-care practices (exercise, journaling, yoga, meditation, etc.) throughout my clinical; they will help keep me balanced. Reviewing my books and taking notes will also help me to be more prepared and feel more confident.”

External Level Actions (Involving Others): “I will inform my supervisor of my preferred learning style and communicate openly and honestly from the start. It is important for me to let him/her know of any performance issues or concerns I may be having that require his/her attention. If I don’t let him/her know what is going on with me, he/she won’t be able to help, so it’s up to me to communicate.”