trainees in difficulty

Trainees in Difficulty

Dr Ken McHardyConsultant DiabetologistAssociate Postgraduate DeanMember NES Faculty Development AllianceAberdeen

ken.mchardy@nes.scot.nhs.uk

RAC Conference Workshop, RCPE 5th June 2014

Aim 1:

TO INCREASE CONFIDENCE AND COMPETENCE IN RECOGNITION OF PROBLEMS AND CONSIDERING UNDERLYING CAUSES

Definitions • Personal conduct– performance or behaviour not associated with the exercise

of medical duties• Professional conduct– performance or behaviour arising from the exercise of

medical duties• Professional competence– adequacy of performance related to the exercise of technical

skills and professional judgement

Problems and Causes

• There are several types of underlying problem

• The manifestation may not reveal the problem

• There are usually several contributory factors

• Attempts at resolution are facilitated by

understanding

• Modelling can be perhaps useful….

Knowledge & Skills

Attitudes & Behaviour

Health

Working Environment

External Environment

Knowledge & Skills

Attitudes & Behaviour

Health

Working Environment

External Environment

• Trainee

• Trainer

• Post

• Workplace

• External

Expectations : Experiences : Culture : Support

Induction : Resilience : Other Responsibilities

Aim 2:

TO RAISE AWARENESS OF STRUCTURES AND RESOURCES TO HELP MANAGE SITUATIONS WHERE TRAINEES ARE HAVING DIFFICULTIES

GMC

Health Boards

DME

NES

Educational Supervisor

Clinical Supervisor

TPD

Royal Colleges

College Tutor

Trainee

NES Support Structure• NES Policy• Operational Framework• Trainee Performance Advisory Group

www.nes.scot.nhs.uk > Education and Training > Medicine > Help and Support (bottom left) > Doctors in Difficulty…

NES OPERATIONAL FRAMEWORK

–Ten guiding principles- Classification of problems- Roles and responsibilities- Levels of seriousness- Resources for remediation and

assessment- Ill health- Contact details

Guiding Principles1. Ensure patient safety2. Address problems as they occur3. Find out the facts4. Speak to the trainee – two sides to every story5. Consider underlying health problems6. Seek help / guidance if uncertain7. Set realistic measurable goals8. Document everything9. Be proportionate, consistent and fair10.Confidentiality

Aim 3:

To EMPHASISE THE PARAMOUNT IMPORTANCE AND RELATIVE SIMPLICITY OF TIMELY INTERVENTION

Educational Practice or Clinical Practice

Early Detection Early intervention Knowing the processes……. and who is there to help? Prevention better than cure!

REMEMBER!While all trainees have problems of some sort or another during training, most trainees progress satisfactorily most of the time without coming anywhere near to a definition of ‘doctor with difficulty’