Struggling urology trainee: a qualitative study into causes of underperformance

Area of Science:

• Medical Education
• Surgical Training
• Urology

Background:

• Underperforming urological surgical trainees are difficult to identify and manage.
• Current systems rely on untrained supervisors, straining resources.
• Limited data exists on the complex reasons behind trainee underperformance.

Purpose of the Study:

• To explore the complex factors contributing to underperformance in urological surgical trainees.
• To inform the development of improved remediation strategies for underperforming trainees.

Main Methods:

• Qualitative study utilizing semi-structured interviews.
• Interviews conducted with urology consultants and an educational manager.
• Thematic analysis of transcribed interview data.

Main Results:

• Identified five key themes: underperformance as a profound issue, the spiral of failure, the changing trainee, lack of insight, and unsupported supervisors/posts.
• Behavioral issues were deemed the most likely and challenging cause of underperformance.
• Causative factors related to both trainee characteristics and the training/supervision environment were identified.

Conclusions:

• Underperformance in urology trainees is complex and multifactorial.
• Addressing behavioral issues, alongside trainee and training-related factors, is essential for effective remediation.
• Improved understanding of these complexities is vital for successful trainee outcomes.