GP registrars with difficulties
Prevention
- Clinical supervisors talking to educational supervisors
- Start early
- Make time
- Flexible training
- Self awareness
Issues
- Short rotations give little time to develop relationships and address issues
- Advice from "experts" may be of variable quality
- The opposite of "competent" is "in training" not "incompetent"
- Role conflict between appraiser, supporter and adviser.
- Avoid labelling
- Complex multiple issues, not cause and effect
- The model is a parallel to the doctor-patient consultation, the skills are generic
- Blame culture gets in the way
- System or organisational problems might be personalised - "it's the person, not the problem"
- Gut feeling > intuition > behavioural characteristics > evidence
- Doctors "never become ill"
- Stressors at work
- Control
- Demand
- Support
- Relationships
- Change
- Management style
- Organisational issues
- "Teams" or "groups of individuals"?
- Personality issues - identify changeable behaviour
- Societal factors