Mentoring through Performance Failure- Classroom to Clinic to Residency
Purpose
Challenges arise with learners when performance does not meet standardized expectations. The purpose of this talk is to go through the pathway from clinical performance challenge to ultimate success or failure in clinical practice from the perspective of the clinical educator.
Methods and/or Description of Project
The biggest challenge clinical educators’ face is how to continue to mentor and encourage performance in the midst of failure. Challenges can be didactic in nature and decisions must be made if re-learning is possible without re-taking academic courses, is remediation reasonable without re-teaching core courses? How pervasive is the knowledge gap? This information can often predict the volume of self-study required as a minimum foundation for clinical success. In other cases, the pervading deficit is not a knowledge gap but one of performance. Those who can say the correct answer but can't seem to do the most appropriate action often require a very different approach. Early determination of the most limiting factors for success can provide insight into a comprehensive remediation plan. The spectrum of remediation designs will be reviewed with insights from clinical educators with over 50 collective years of clinical and residency instruction. The balance of providing encouragement without implying success will be reviewed. And in those cases where the inability to achieve passing criteria results, the documentation and even subsequent grievance preparation and responses will be reviewed.
Results/Outcomes
Failure in clinical practice is never the plan for either the student/resident or the clinical faculty, however, it is inevitable if standards are consistently high. Mentoring through failure is a necessary skill for those involved in clinical training.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
The Pursuit of Excellence in Physical Therapy Education requires that consistently high standards are established and upheld in the assessment of the career entry or residency/fellow trainees. Failure is an inevitable consequence of underperforming to minimal standards. Discussing the reality of these cases is essential to the representation of the expectations of the clinical education faculty.
References
Stephanie Jones, Chuck Bellah, Joseph J. Godges, A Comparison of Professional Development and Leadership Activities Between Graduates and Non-graduates of Physical Therapist Clinical Residency Programs J of Physical therapy Education Vol 22, No 3 2008 86-89
Description of Orthopedic Specialty Practice American Physical Therapy Association 2015
Ellen Wruble Hakim, Marilyn Moffat, Elaine Becker, Karla A. Bell, Tara Jo Manal, Laura A. Schmitt, Cathy Ciolek Application of Educational Theory and Evidence in Support of an Integrated Model of Clinical Education J of Physical Therapy Education 28;1 2014 p13-21
Jeffries PR, Rose L, Belcher AE, et al. A clinical academic practice partnership: a clinical education
redesign. J Prof Nurs. 2013;29(3):128–136.
Svinicki MD, Wilkerson L. Faculty development for workplace instructors. In: Hafler J, ed.
Extraordinary Learning in the Workplace. New York, NY: Springer; 2011.
Course Objectives
Upon completion the learner will be able to:
1. Identify examples of performance challenges related to inadequate knowledge or adequate knowledge with inadequate performance.
2. Describe remediation expectations that build or develop over time toward improved performance.
3. Identify feedback language that reflects performance improvements without implying predicted future success.
4. List the typical grievance steps/process and the role of the clinical educator in documentation and preparation for these procedures.
Instructional Methods
Lecture with case examples and group discussion and panel discussion
Tentative Outline/Schedule
Introduction (5min)
Early Warning signs of clinical performance deficits (10 min)
Determination of knowledge deficit, performance deficit or combination with case examples (15 min)
Discussion (5 min)
Remediation- what resources are available with how to case examples (15 min)
Discussion (5 min)
Ongoing Feedback- just the facts (10 min)
Realistic assessment of performance against standardized criteria and the failure to meet performance expectations (5 min)
When failure leads to grievance, the documentation and preparation (15 min)
Discussion (5 min)