The “Problem Trainee”

1. The “Problem Trainee” Ronald D. Szyjkowski, MD, FACG Upstate Medical University SUNY Syracuse

2. Objective Consider the difficulties Ways to help the trainee succeed Help your peers & your program respond Plan interventions Additional resources

3. Objective Consider the difficulties Ways to help the trainee succeed Help your peers & your program respond Plan interventions Additional resources

4. The Difficulties the “ProblemTrainee” is Presenting Is there impairment? Mental Illness Drugs / Alcohol Illness “one who is unable to practice medicine with reasonable skill and safety because of mental illness or excessive use or abuse of drugs; including alcohol”

5. The DifficultiesSigns of Impairment Loss of enthusiasm Negativity Cynicism Antagonism Complaints Overworked Misunderstood Isolationism Hawes, GE Clin NA 5:2 1995

6. The DifficultiesImpairment You will need help.

7. TheDifficulties Directly affect patient care and Do not directly affect patient care What did / what could you do?

8. The Difficulties Box Groups

9. The Difficulties Directly affect patient care and Do not affect directly patient care What did / what could you do?

10. The Difficulties Flip Chart

11. The DifficultiesDirectly affect patient care Humanistic qualities Negligence Ethical conduct Deficient knowledge base Poor clinical judgment Absence / tardiness

12. The Difficulties Does not directly affect patient care Peer interactions Staff interactions Cheating Lack of commitment to learning Professional behavior Absence / tardiness

13. Objective Consider the difficulties Ways to help the trainee succeed Help your peers & your program respond Plan interventions Additional resources

14. Objective Consider the difficulties Ways to help the trainee succeed Help your peers & your program respond Plan interventions Additional resources

15. Objective Consider the difficulties Ways to help the trainee succeed Help your peers & your program respond Plan interventions Additional resources

16. Trainee Success Define the assessment terms Set objectives Explain the appraisal process Recognize the importance of feedback Communicate Have a curriculum

17. Program Success Teachers need to: Train for the assessment Know the objectives Follow the appraisal process Provide meaningful and timely feedback

18. Program Success Teachers need to: Train for the assessment Know the objectives Follow the appraisal process Provide meaningful and timely feedback Be taught how to be teachers!

19. Program Success Teachers need to: Train for the assessment Know the objectives Follow the appraisal process Provide meaningful and timely feedback Have a curriculum ...with a plan for intervention

20. Objective Consider the difficulties Ways to help the trainee succeed Help your peers & your program respond Plan interventions Additional resources

21. Interventions Need clear documentation of the problem Ideas?

22. InterventionsEscalation Documentation of lack of resolution Inform GME Plan for remediation Goals Dates Reassessment

23. InterventionsDocumentation Need clear documentation of the problem Specific observations Date, times and persons involved Clarify any vagueness Record what was done and what was planned / instructed Trainees understanding

24. Objective Consider the difficulties Ways to help the trainee succeed Help your peers & your program respond Plan interventions Additional resources