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
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Medical knowledge
IT
Systems
Patient pathways
Areas of difficulty – skills
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Time management
Data interpretation
Problem solving
Communication
Organisation
Areas of difficulty - attitudes
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Low motivation
Poor attitudes to patients
Poor attitudes to colleagues
Poor self assessment/awareness
Strained relationship with supervisor
Areas of difficulty – health & social
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Mental health
Physical health
Burn out
Childcare
Relationship difficulties
Drug & alcohol issues
Criminal
How do you know?
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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
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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
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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
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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
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Disclose problems early
Meet as requested
Agree to share educational plan
Take responsibility for implementing
change
• Meet targets set
Responsibilities of educational
supervisor
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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
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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