Trainees in difficulty—or a system in difficulty?

The “trainee in difficulty” (TID) can have multiple causative factors which can impact the delivery of an expected standard of skill sets. The communication and interpersonal skills in Emergency Department (ED) setting are key to any trainee’s performance in an ED environment where team playing is a major factor in achieving safe and holistic care for patients. Trainer or a young faculty member responsible for the training may not have the emotional intelligence or experience to deal with all the issues faced by the TID. This paper talks about the difficulties faced by an experienced trainee in difficulty, who has changed his career from an experienced ED nurse to a trainee registrar in Emergency Medicine. The second case study is about a young emergency medicine residency program director who fails to appropriately address a trainee’s situation and compounds the trainees’ issues. The effect of honest, transparent communication of an educational supervisor and setting clear goals for the TID can have a huge impact on trainees’ performance. A residency program director’s inexperience and poor skills to deal and escalate the trainee’s issues may jeopardize a young physicians’ career.

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“…When exploring a TID, the following areas have to be explored [ [9] , [10] , [11] ]. Are there lapses in clinical knowledge and skills?…”

Section: Casementioning

confidence: 99%

Managing the ambiguity of the trainee and the trainer

Qureshi

Butt

2021

International Journal of Pediatrics and Adolescent Medicine

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“…Whilst these reasons relate to performance on the day of assessment, research suggests a number of other factors are associated with failure at assessment. These include: GP trainee demographics (non-UK status, black and ethnic minority background and male gender) [6,7]; issues related to day-to-day practice; training and education (heavy workload, reduced work-life balance, poor trainee-trainer relationship) [8][9][10]; health and well-being (stress, burnout and mental illness) [11,12]; conduct and attitude (motivation, low confidence, poor reflective capacity) [13,14]; and finance [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

A qualitative exploration of the lived experience of GP trainees failing to progress in training

Winter

Norman

Patel

2020

Education for Primary Care

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Challenges facing general practice are multiple and extreme. Amongst them is the increasing difficulty of recruiting and retaining General Practitioners (GPs). GPs cite heavy workload, workrelated stress, little family time and psychological ill-health as factors influencing their decisions to leave or reduce working hours. Analysis of the literature suggests that these factors, amongst others, are present in GP training and trainees have similar experiences. An in-depth understanding of the challenges trainees in difficulty face is lacking. Our research aim was to better understand the factors that trainees perceive contribute to their failure to progress in training. A qualitative approach was adopted using semi-structured interviews with GP trainees identified as failing to progress satisfactorily or failing the MRCGP examinations. Interviews were audio-recorded and transcribed. Thematic analysis was used to understand the unique experiences of GP trainees and find common themes. Twenty-three interview transcripts were analysed. Emergent themes were presented using a framework of three distinct categories to aid data organisation and allocating themes and subthemes: professional factors, personal factors, and social factors. Difficulties with managing workload, poor motivation, lack of family time and psychological ill-health were significant themes for many. This study supports the evidence that difficulties facing GPs take root in training. Failure to fully understand trainees' journeys and associated challenges reduces opportunities to provide bespoke packages of care and remediation that fully address their needs.

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Trainees in difficulty—or a system in difficulty?

Cited by 2 publications

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Managing the ambiguity of the trainee and the trainer

Managing the ambiguity of the trainee and the trainer

A qualitative exploration of the lived experience of GP trainees failing to progress in training

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