Learner difficulties, issues and problems

 

  • What is the problem?
  • Who is it a problem for?
  • What is the effect of the problem?
  • Am I prepared to put up with the problem?
  • Does the registrar accept there is a problem?
  • Is there an underlying reason for the problem?
  • What changes are we trying to negotiate?
  • What are the consequences if changes agreed?
  • What are the consequences if changes not agreed?
  • What options are there for addressing the problem?
  • Which is the best option?
  • Who should deal with the problem?
  • Does this create a knock-on problem?
  • Is the registrar happy with the outcome?
  • Spell out the consequences
  • How can the resolution be monitored?

 Guidelines for addressing problems

  • Use general feedback principles
  • Address the problem as soon as it becomes apparent
  • Be specific, use examples
  • Address the problem not the person
  • Express your feelings about the behaviour
  • Allow discussion
  • Let the registrar suggest solutions
  • Appropriate time, place, setting
  • Don’t use humour
  • Summarise
  • Spell out consequences
  • Arrange follow-up
  • Look for hidden issues
Managing the problem Example
What is the problem? Registrar is frequently late for surgery
Who is it a problem for? Staff, patients, other doctors
What is the effect of the problem? Patients angry, staff flustered, doctors see extras
Does the registrar accept there is a problem? Yes / no
Is there an underlying reason for the problem? Registrar has to drop child at school
Am I prepared to put up with the problem? Yes/no
What changes are we trying to negotiate? Better time keeping
What are the consequences if changes agreed? On time for surgery
Problem at home
What are the consequences if changes not agreed? Late for surgery
No anxiety re family
What options are there for addressing the problem? 1. Alternative child arrangement
2. Change surgery times
Which is the best option? Less disruptive to surgery system
Who should deal with the problem? 1.staff
2.practice manager
3.trainer
Does this create a knock-on problem? Possible increased anxiety over family
Is the registrar happy with the outcome? Yes / no
Spell out the consequences 1. Signing up
2. Reference
3. Dysharmony between phct
4. Setting precedent
How can the resolution be monitored? Feedback from staff, patients
Discussion in teaching sessions

Classification of potential registrar problems

Knowledge Skills Attitudes
Prescribing Communication I’m the doctor
Emergencies Consulting I’m qualified now
Surgery protocols Practical eg min surgery, self education Time keeping
Team roles Preparation
Red book On call
Availability
Dress
Behaviour
Flexibility re workload
Self-confidence
Motivation
Organisation
Delegation
en English
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