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Related Experiment Videos

A prerogatives-based model for assessing and managing the resident in difficulty

M J Gordon1

  • 1Department of Family Medicine, University of Washington, Seattle.

Family Medicine
|November 1, 1993
PubMed
Summary

This study presents a structured approach for managing resident noncognitive and attitudinal issues. It uses a two-cycle assessment to foster early intervention and support resident autonomy while maintaining faculty oversight.

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Area of Science:

  • Medical Education
  • Psychology
  • Professional Development

Background:

  • Managing residents with noncognitive and attitudinal difficulties presents challenges due to unclear boundaries between faculty and resident roles.
  • Frustration often arises from the ill-structured nature of assessing and addressing these complex performance issues.

Purpose of the Study:

  • To describe a comprehensive, well-tested model for managing residents exhibiting noncognitive performance and attitudinal difficulties.
  • To introduce a structured, two-cycle assessment process to address these challenges effectively.

Main Methods:

  • The proposed model divides nonroutine assessment into two cycles: a "work-up cycle" where residents are primary decision-makers for suspected issues, and a "probation cycle" where faculty are primary decision-makers for more serious concerns.

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  • It advocates for a collaborative "let's find out" approach to encourage early issue identification and support resident autonomy and professional responsibility.

    • Main Results:

    • The model facilitates early identification of suspected issues by faculty.
    • It supports resident autonomy and professional responsibility while ensuring faculty oversight.
    • The approach replaces adversarial positioning with a constructive problem-solving framework.

    Conclusions:

    • This structured, two-cycle model provides a clear framework for managing residents with noncognitive and attitudinal difficulties.
    • It promotes a supportive yet accountable environment, respecting faculty discretion in trainee assessment and contract management.