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Learners in Difficulty

Learners in Difficulty. Problem Resident. “Trainee who demonstrates a significant enough problem that requires intervention by someone of authority, usually the program director or chief resident.” ABIM. Working with learners in difficulty. Prevention Identification SOAP. Prevention.

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Learners in Difficulty

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  1. Learners in Difficulty

  2. Problem Resident “Trainee who demonstrates a significant enough problem that requires intervention by someone of authority, usually the program director or chief resident.” ABIM

  3. Working with learners in difficulty Prevention Identification SOAP

  4. Prevention Primary : Prevent it before it happens Secondary: Early detection Tertiary Seek help to manage the problem

  5. Primary Prevention Effective Orientation Provide learner with objectives Set clear expectations Set learner rules Determine learner’s expectations and objectives Provide feedback mid-course

  6. Secondary Prevention Early Detection/Identification Three types of difficult learners Clinical incompetence Unprofessional behavior Unprofessional attitudes

  7. Clinical Incompetence Inexperienced Lack of medical knowledge/skills Inability to apply knowledge and solve problems

  8. Organization of Knowledge Reduced knowledge Absent or inaccessible Dispersed knowledge Unrelated, out-of-context Elaborated knowledge Multiple abstract associations, in context Compiled knowledge Concise, experienced

  9. What do you do with “reduced” learners? Provide “advance organizers” Add structure to clinical experiences eg. Simulations, mini-assignments relating to clinical cases Turn “down time” into “clinical learning time” Ready access to networked computers

  10. What do you do with dispersed learners? Skills or Knowledge?? Skills “Practice” with SPs, simulators Knowledge Use of “real” clinical cases to solve problems Compare and contrast similarities and differences

  11. What do you do with elaborated learners? Make sure that there is no “premature closure” Check analytic reasoning pathways Enquire about non-analytical reasoning Add readings

  12. Unprofessional Behavior Chronic lateness Poor cooperation and collaboration Personal appearance Lack of integrity Disrespectful toward others Lack of empathy/compassion No self-insight

  13. Unprofessional Attitudes Insecure learner Prejudiced learner Apathetic learner Reductionist learner

  14. Tertiary Prevention Need to “refer” to a more knowledgeable/senior person SEEK HELP

  15. Preceptor Problems Health issues Personal, family Practice Issues Staffing, financial issues, schedules Relationship Issues Personality clash with learner

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