The Problem Trainee

Definition

• One who fails to meet the expectations of the training programme because of a problem with knowledge, skills, attitude or health

GMC - Good Medical Practice

16. If you are involved in teaching you must develop the skills, attitudes and practices of a competent teacher.

18. You must be honest and objective when appraising or assessing the performance of colleagues, including locums and students. Patients will be put at risk if you describe as competent someone who has not reached or maintained a satisfactory standard of practice.

Areas of difficulty - knowledge

• Medical knowledge

• IT

• Systems

• Patient pathways

Areas of difficulty – skills

• Time management

• Data interpretation

• Problem solving

• Communication

• Organisation

Areas of difficulty - attitudes

• Low motivation

• Poor attitudes to patients

• Poor attitudes to colleagues

• Poor self assessment/awareness

• Strained relationship with supervisor

Areas of difficulty – health & social

• Mental health

• Physical health

• Burn out

• Childcare

• Relationship difficulties

• Drug & alcohol issues

• Criminal

How do you know?

• Gut feeling• Case review – including CBD/COT• Significant events• Complaints• Observations by colleagues• Absence / poor attendance at HDR etc• Audit• Lack of preparation for tutorials etc

First define the problem

• What is wrong?• Who is it a problem for?• Effects of the problem?• Is this part of a pattern?• Does it need addressed?• Does the trainee realise they have a

problem?• What can we do about it & when?

A way forward

• Discuss with trainee & colleagues

• Understand from trainees perspective

• Explain concerns

• Do they acknowledge concerns?

• Tactful, empathy, respect

• Challenge where appropriate

• Share responsibility for problem solving

Educational action

• Develop learning plan to address concerns

• Aim to engage & motivate

• Set targets

• Review progress

Attitudinal issues

• More difficult to address

• Is the supervisor part of the problem??

• Get support from those who have been there before!

Health & social issues

• Encourage to engage with appropriate services

• OH support

• Leave of absence

Responsibilities of GPStR

• Disclose problems early

• Meet as requested

• Agree to share educational plan

• Take responsibility for implementing change

• Meet targets set

Responsibilities of educational supervisor

• Identify problems early

• Share concerns with GPStR

• Liaise with deanery structure

• Review targets set & take action if not met

• Document, document, document!

• Assure due process – fair etc

Summary

• Identify and tackle issues at an early stage

• Find out facts – 2 sides to every story

• Seek advice & support early

• Share responsibility for problem sharing

• Document, document, document!

Resources

• Good Medical Practice

• Dealing With Problems That Arise During The GPST . A Booklet for Trainers.

• BMA

• Defence Union

• Occupational Health