Supporting Weak Students

1. Supporting Weak Students

2. Introduction • One of most challenging roles for supervisors • Supervisors and assessors have a duty to confirm students are capable of safe and effective practice • One reason the above may not happen (ie fail to fail) is lack of knowledge of the assessment process

3. Common indicators • inconsistency in meeting required level of competence for stage of training • inconsistent clinical performance • lack of insight into weaknesses so unable to change following constructive feedback • unsafe practice • not responding appropriately to feedback • lack of interest or motivation .

4. Common indicators • limited practical interpersonal and communication skills • absence of professional boundaries and/or poor professional behaviour • experiencing continual poor health, feeling depressed, uncommitted, withdrawn, sad, tired, listless • unreliability, persistent lateness/absence • preoccupation with personal issues • lack of theoretical knowledge

5. Students are entitled • to receive timely feedback about their performance and have the opportunity and support to correct performance considered unsatisfactory • to be aware that their performance is not meeting the criteria set for satisfactory performance

6. Plan of action • don’t ignore • discuss “gut feelings” with suitable colleagues as soon as possible for confirmation • identify, document and feedback concerns to student at earliest opportunity. • explain concerns (perhaps with reference to learning outcomes and criteria required for successful outcome of placement year)

7. Plan of action • give advice on how to improve • agree time frames within which the improvement is expected • inform of consequences should required improvements not occur • discuss with HEI • provide regular feedback and use learning contract (as with all students but possibly more frequently) • address student’s feelings of anger/failure and provide honest, detailed feedback with examples (with documentation)

8. Plan of action • look at yourself – is student clear about expectations?/ are this expectations realistic?/do not have any hidden criteria (clinical assessment is inherently subjective)? • invite students to evaluate their own performance against required outcomes • listen to student’s concerns and acknowledge their opinions • build student’s self esteem -highlight achievements and strengths • remain positive and supportive

9. Evidence • important to collect and document evidence • supports decision that student has not met criteria for successful completion of placement • conversely protects competent student against an irresponsible decision l • documentation should be • factual, non judgemental, identifies strengths and weaknesses with examples • each feedback session should be recorded with details of supportive measures and learning opportunities provided to enable student to improve • feedback from other staff, patients and relatives

10. Reactions to poor outcome • may need time to grieve for loss of personal dream • will need time to digest reality and discuss feeling with supervisor • disbelief and shock –? due to inaccurate self assessment/due to lack of clarity in feedback • betrayal and hurt – by a friend may have interpreted nurturing and supportive role of supervisor as friendship

11. Reactions to poor outcome • cry – allow time • anger/aggression/denial – may be verbally abusive/accusatory. If anger anticipated – have 3rd person present. • blame others – supervisors, placements, university • relief!

12. Effect on supervisor/team • unpleasant • messy • emotionally fraught • sadness • anger • exhaustion • relief • sense of personal failure • disharmony in team – students going behind supervisor’s back

13. Acknowledgements Many thanks to Dr Kathleen Duffy at Glasgow Caledonian University for much of the material contained in this presentation