Transcript Trainees in Difficulty - Royal College of Physicians of

RAC Conference Workshop, RCPE 5th June 2014
Trainees in Difficulty
Dr Ken McHardy
Consultant Diabetologist
Associate Postgraduate Dean
Member NES Faculty Development Alliance
Aberdeen
[email protected]
Aim 1:
TO INCREASE CONFIDENCE AND
COMPETENCE IN RECOGNITION OF
PROBLEMS AND CONSIDERING
UNDERLYING CAUSES
Definitions
• Personal conduct
– performance or behaviour not associated with the exercise
of medical duties
• Professional conduct
– performance or behaviour arising from the exercise of
medical duties
• Professional competence
– adequacy of performance related to the exercise of technical
skills and professional judgement
Problems and Causes
• There are several types of underlying problem
• The manifestation may not reveal the problem
• There are usually several contributory factors
• Attempts at resolution are facilitated by
understanding
• Modelling can be perhaps useful….
Working Environment
Knowledge &
Skills
Attitudes &
Behaviour
Health
External Environment
Working Environment
• Trainee
• Trainer
Knowledge
& Skills
Attitudes &
Behaviour
• Post
• Workplace
• External
Health
External Environment
Expectations : Experiences : Culture : Support Induction
: Resilience : Other Responsibilities
Aim 2:
TO RAISE AWARENESS OF
STRUCTURES AND RESOURCES TO
HELP MANAGE SITUATIONS WHERE
TRAINEES ARE HAVING DIFFICULTIES
Royal
Colleges
GMC
Health Boards
NES
DME
TPD
Educational
Supervisor
Clinical Supervisor
Trainee
College Tutor
NES Support Structure
• NES Policy
• Operational Framework
• Trainee Performance Advisory Group
www.nes.scot.nhs.uk > Education and Training >
Medicine > Help and Support (bottom left) >
Doctors in Difficulty…
NES OPERATIONAL FRAMEWORK
–Ten guiding principles
- Classification of problems
- Roles and responsibilities
- Levels of seriousness
- Resources for remediation and
assessment
- Ill health
- Contact details
Guiding Principles
1. Ensure patient safety
2. Address problems as they occur
3. Find out the facts
4. Speak to the trainee – two sides to every story
5. Consider underlying health problems
6. Seek help / guidance if uncertain
7. Set realistic measurable goals
8. Document everything
9. Be proportionate, consistent and fair
10.Confidentiality
Aim 3:
To EMPHASISE THE PARAMOUNT
IMPORTANCE AND RELATIVE
SIMPLICITY OF TIMELY
INTERVENTION
Educational Practice or
Clinical Practice
 Early Detection
 Early intervention
 Knowing the processes…
…. and who is there to help?
 Prevention better than cure!
REMEMBER!
While all trainees have problems of some
sort or another during training, most
trainees progress satisfactorily most of the
time without coming anywhere near to a
definition of ‘doctor with difficulty’