1. Supporting Learners

2. Session objectives Identify problems that may affect learning Identify a framework for supporting learners Recognise prevention and management strategies for supporting learners

3. Problems affecting learning Supervision Competence Communication Personal Professional System Environment Personnel Process Learner Competence Communication Personal Professional

4. 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

5. Framework for Supporting Learners

6. Additional considerations Early identification is critical Maintain documentation Active involvement

7. 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

8. The slow learner Unfamiliarity with time expectations Poor knowledge &/ or skills Fear of failure Slowness to avoid new tasks Language problems Address directly & use concrete examples Explanation & time for practise Encouragement Clear explanation of expectations Use effective strategies with learners from NESB

9. 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

10. 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

11. 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

12. Strategies prevention & management Preparation Seek assistance (e.g. university, manager) Defuse & debrief after critical incidents Tailor individual intervention Provide focused & structured teaching Consult student

13. 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

14. 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

15. 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

16. Activity Conversation starter Action plan

17. What questions do you have?

18. 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.

19. 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