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Related Experiment Videos

Defining the "Problem Resident" and the Implications of the Unfixable Problem: The Rationale for a "Front-door"

Taku Taira1,2, Sally A Santen3, Nicole K Roberts4

  • 1LAC+USC Medical Center, Department of Emergency Medicine, Los Angeles, California.

The Western Journal of Emergency Medicine
|January 16, 2019
PubMed
Summary

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This summary is machine-generated.

Problem residents in emergency medicine residencies create turbulence. A new definition, "a resident with a negative sphere of influence beyond their personal struggle," better captures these challenging trainees.

Area of Science:

  • Medical Education
  • Graduate Medical Training
  • Emergency Medicine

Background:

  • Problem residents are prevalent in graduate medical education, particularly in emergency medicine (EM).
  • Existing definitions lack specificity, hindering effective identification and intervention.
  • Understanding characteristics and consequences is crucial for residency programs.

Purpose of the Study:

  • To add granularity and nuance to the definition of a "problem resident."
  • To guide the recruitment, selection, and training of residents.
  • To explore emergency medicine program directors' perspectives on problem residents.

Main Methods:

  • Semi-structured interviews with EM program directors (PDs) from 2011-2012.
  • Qualitative thematic analysis based on grounded theory principles.

Related Experiment Videos

  • Team-based coding through consensus until thematic sufficiency.

    • Main Results:

    • Diversity in problem type, severity, fixability, and attribution among problem residents.
    • PDs often rejected the ABIM definition, using varied thresholds.
    • Personality problems were deemed "non-fixable," while academic/medical issues were often "fixable."
    • Consensus identified residents causing "turbulence" as problem residents.

    Conclusions:

    • The ABIM definition is insufficient; a new definition is proposed: "a resident with a negative sphere of influence beyond their personal struggle."
    • This definition incorporates turbulence and diverse thresholds.
    • A "front-door" solution focusing on personality issues is needed, requiring stakeholder commitment.