Supporting Learners

Session objectives

• Identify problems that may affect learning

• Identify a framework for supporting learners

• Recognise prevention and management strategies for supporting learners

Problems affecting learning

Supervision

CompetenceCommunication

Personal Professional

System

EnvironmentPersonnelProcess

Learner

Competence Communication

Personal Professional

Challenges

• Confirming problem

• Analysing the cause

• Identifying available options

• Whose responsibility?

• Role conflict – assess vs mentor

• Supervisor skills and confidence

• Timing

• Lack of system support

Framework for Supporting Learners

Additional considerations

• Early identification is critical

• Maintain documentation

• Active involvement

Red Flags – immediate action• Patient/Client safety

• Learner safety

• Serious misconduct

– Contact manager/educational institution, other as appropriate

– May result in withdrawal from placement, failure of placement, criminal or civil charges depending on situation

– Implications usually joint decision

The slow learner

Unfamiliarity with time expectations

Poor knowledge &/or skills

Fear of failure

Slowness to avoid new tasks

Language problems

Address directly & useconcrete examples

Explanation & time forpractise

Encouragement

Clear explanation of expectations

Use effective strategieswith learners from NESB

The learner with poor interaction skills

Brusque

Uncaring

Unkind

Outwardly condescending or insulting

Unacceptably familiar

• Does the learner has insight?Use data, comments from staff, observations from others, ask learner

• Make the learner aware of the outcome their behaviour & impact on others

• Set clear standards of acceptable rules of conduct

• Establish time to revisit these concerns & adhere to the plan

The unmotivated learner• Are you providing

relevant learning opportunities?

• Are there clear directions as to expectations, responsibilities?

• If yes – & learner remains unmotivated then you have a problem!

• Long term• Acute • Subject matter

• Diagnose the problem accurately, this will determine your response

• Give time & empathy

• Use adult learning principles

The incompetent learner

Poor knowledge

Poor skills

Poor confidence

Poor understanding of task

Give self learning tasks

Allow time for practice and repetition

Encouragement, low stress environment

Clear explanation (verbal +/- written) of tasks and intended outcomes

Strategies prevention & management

• Preparation

• Seek assistance (e.g. university, manager)

• Defuse & debrief after critical incidents

• Tailor individual intervention

• Provide focused & structured teaching

• Consult student

Strategies prevention & management

Remediation activities

• Clinical learning contracts• Individualised performance review• Practise • Clinical observation• Tutoring

• Strict formative & summative assessment plan

• Be prepared to act on outcomes of assessment

• Document

Put things in perspective

• Talk to learner about “worse case” scenario

• Don’t beat yourself up – sometimes learners will struggle/fail, despite all your efforts

Summary• Take the problem learner seriously

• Identify an issue early

• Utilise resources & make your interventions clear

• Have a clear plan

• Support change

• Document the process

• Keep things in perspective

Activity• Conversation starter

• Action plan

What questions do you have?

References

Dudek, N.L., Marks, M.B. & Regehr, G. (2005). Failure to fail: The perspectives of clinical supervisors. Academic Medicine, 80(10), pp S84 – S87.

Grace, K. (2002). The junior doctor in distress: the role of a medical education officer at the individual level, MJA, 177, S22 – S24.

Hauer, KE., Teherani, A., Irby, D.M., Kerr, K.M. & O’Sullivan, P.S. (2008). Approaches to medical student remediation after comprehensive skills examination. Medical Education, 42: 104 – 112.

Luhanga, F., Yonge, O. & Myrick, F. (2007). Precepting an unsafe student: the role of the faculty. Nurse Education Today, 28: 227 – 231.

References

Moeller,1997; Maloney et al,1997, as cited in CPAC, 1997; Fitzgerald, 2007

Morrison, J. (2008). Professional behaviour in medical students and fitness to practise. (Commentary). Medical Education, 42: 118 – 120.

Scanlan, J.M., Care, W.D. & Gessler, S. (2001). Dealing with the unsafe student in clinical practise. Nurse Educator, 26(1) pp 23 – 27.

Teeter, M. (2005). Formula for success: Addressing Unsatisfactory Clinical Performance. 30 (3), pp 91 – 92.

Acknowledgements; Adam, K. address issues early on and document, document, document" OT clinical educator, workplace rehabilitation practice (personal communication, May 10, 2007) and S. Bartholomai, OT clinical educator, collaborative placement model (personal communication, May 31, 2007)

Debra Kiegaldie, Centre for Medical & Health Sciences Education. Monash University