Practice makes perfect: dealing with poor performance issues

Sep 5, 2014

A Registrar and a Consultant who had a complaint filed against them by a Medical Student who had failed a hospital rotation with little warning, demonstrates why giving constructive feedback to students and junior doctors, is a vital skill every doctor should learn.

A member highlighted the case of a Medical Student who was stunned when her university notified her via mail that she had failed her last hospital rotation for the term, for displaying poor communication skills with patients.

Having successfully completed her other hospital rotations, she was incensed because she had not received any prior negative feedback from her supervising Consultant and Registrar, and was unaware she had failed the hospital rotation until receiving the notification.

Arguably, the Consultant and Registrar did not provide the Medical Student with appropriate verbal feedback on her performance, including details of the performance issue, examples of when it occurred, or constructive feedback on how she could improve her communication skills.

Subsequently, the Medical Student made a formal complaint against the senior members of the team, and was eventually able to complete her rotation in another unit.

Constructive feedback

Performance issues can arise due to a variety of reasons, including lack of knowledge or skill, or intercurrent life stressors. Whatever the issue is, constructive feedback is key.

In most instances the Registrar or Resident Medical Officer (RMO) will have the most contact with the Junior Medical Officer (JMO) or Medical Student, and will be well placed to assess their performance. However, commonly the responsibility for feedback rests with the Consultant.

In this situation, as a first step any concerns that you have about performance should be addressed early and informally discussed with the Medical Student or JMO. If your concerns continue and are likely to impact any report, your feedback should be formalised in writing and the Consultant responsible, should be involved.

Providing constructive feedback about poor performance is not easy and like any other skill, it requires practice. Feedback should address both the team member’s strengths and weaknesses. It should be specific and ideally provided close to the events that have caused concern.

There are a number of courses that can also help, such as 'Teaching on the Run', which provides up-skilling on teaching and supervision in the clinical setting.

Life stressors

It is important to be aware that poor performance in a Medical Student or JMO may be reflective of other life issues they are going through. An open and non-punitive approach to giving any feedback can encourage a person to reveal these stressors, particularly if invited.

If problems emerge, there are a number of strategies that can be used to assist, including giving a person time off, revising their roster to alleviate pressure, or referring them to Avant’s Personal Support Program on: 1300 360 364 for confidential counselling, or if appropriate, to their GP.

Learn more

For more information on performance management, visit Avant’s new Health and Wellbeing microsite.

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