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