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Trainees in Difficulty

Trainees in Difficulty. Jim Boddington Hackney Trainers’ Workshop Sept 2012. 1.45 Intro to session 2.00 Trainees in difficulty: strengths as weaknesses; case studies; diagnosis and resolution. 3.00 Tea 3.15 Issues affecting international medical graduates

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Trainees in Difficulty

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  1. Trainees in Difficulty Jim Boddington Hackney Trainers’ Workshop Sept 2012

  2. 1.45 Intro to session 2.00 Trainees in difficulty: strengths as weaknesses; case studies; diagnosis and resolution. 3.00 Tea 3.15 Issues affecting international medical graduates 4.15 Practicalities: when and how to act

  3. Deanery definition The nationally accepted term ‘trainee in difficulty’ describes a doctor in training, who needs extra help and support - beyond that which is normally required - to deal with problem(s) that threaten to delay their completion of a postgraduate training programme.  The purpose of identifying a trainee as being ‘in difficulty’ is not to label them; it is to aid the addressing of relevant issues so that they may complete their training successfully.

  4. In pairs Think of a time when you have had difficulty with your own learning or training.

  5. How strengths become weaknesses(Hogan and Hogan, 1997)

  6. Case studies • Individually, think of a trainee you have supervised and considered to be in difficulty • In groups of 3, share your stories (preserving confidentiality) • Choose one case to consider in detail, with a view to an educational diagnosis • You may need to speculate about underlying causes • Don’t engage in problem solving at this stage • Invest time in problem definition

  7. ASSESSMENT DOMAINS Personality and behaviour Health and home Clinical capability Organisational issues

  8. A model for “diagnosis” • Capacity • Learning • Arousal (Motivation) • Distraction • Alienation

  9. What kind of problem is it?

  10. Matching resolution to diagnosis

  11. Case studies (part 2) • Back in the same groups of 3, try applying this scheme to your case • Clarify the educational diagnosis • What strategies might help resolve the difficulties? • Role play: trainee, supervisor, observer

  12. Do they have the “key” personality traits to help them change? Are they stable enough? Can they persevere? Do they have insight? Are they psychologically minded? Can they reflect on their behaviour and learn from their experience? Do they want/intend to change? Have they a history of successful change attempts? What will motivate them to change? What kind of environment will they be working in? What support is available? What are the contextual factors that may influence their behaviour? What predicts the likelihood of change?

  13. RECOMMENDED APPROACH Act early No surprises – involve learner If it isn’t written down it hasn’t happened Objective – fact not opinion

  14. IMPORTANCE OF EFFECTIVE FEEDBACK • Ask trainee’s point of view and encourage reflection • Phrase feedback in descriptive, non-evaluative language • Be specific not general • Address decisions and actions rather than assumed intentions and interpretations • Be constructive – acknowledge appropriate behaviour as well as areas for improvement

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