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Managing the Trainee in Difficulty

Managing the Trainee in Difficulty

PLEASE NOTE: These modules have now been transferred to the HEE e-Learning for Health platform and should be accessed via

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This suite of modules will be completely decommissioned in September 2017, from which point it will no longer be accessible.

Supporting a trainee in difficulty can be extremely challenging, yet immensely rewarding. This module explores the types of difficulty trainees may experience and considers a range of potential intervention strategies that may be adopted by supervisors to ensure the continuation of a positive training experience for all trainees. In this module we use the term ‘supervisor’ generically, unless there are particular roles for specified members of the training team. Throughout the module we will focus on those areas where educational insights and expertise can have an important impact – in other words, where you can make a real difference. By the end of this module you should have a clearer sense of the types of difficulty trainees may experience, what the underlying causes may be and the strategic interventions you may be able to make (including seeking help from others in the team) to manage and support these trainees.

You will recognise the importance of core educator skills addressed in other modules, e.g. identifying learning needs, effective use of appraisal, supervision and feedback skills, and using workplace-based assessment as the basis of developmental conversations with your trainee. We hope you will also see parallels with your clinical work and recognise the transferable skills you bring to working with the trainee in difficulty. This starts with recognising signs and symptoms of difficulty, followed by a triage process to identify those trainees with difficulties, those who you find ‘difficult’ and those in difficulty. This diagnostic process may result in referral to colleagues with specialist skills and in the formulation of a management or intervention plan with the hope of successful remediation in the longer term.

Lake comments that: ‘reaching those doctors who experience difficulty is certainly challenging, such is the depth of stigma and embarrassment felt by those who struggle in their careers’ (Lake, 2009, p. 612), but goes on to suggest that all of us are likely to face periods of difficulty at some point in our own careers. One starting point when faced with the trainee in difficulty is to consider the type of support and guidance you might want if you were in the same situation.

Before you start

Before you start the module we recommend that you spend a few minutes thinking about the following points and noting down some of your thoughts. If you are registered on the site, you can do this in the ‘reflections area’. Click on the ‘my area’ link at the top of the page to access your personal pages. Please note that you must be logged in to do this. Please also note that you will need to contribute to the ‘reflections area’ during the course of the module in order to complete and print out your certificate.

Thinking points

Consider your own training and identify any difficulties you faced.

  • What types of intervention did you find helpful or wish had been available to you?

Consider your own experience of supporting trainees.

  • What kinds of ‘challenge’ do they face in their training years?
  • What difficulties have you encountered when supervising trainees?



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