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Module 3


Learners in difficulty

If you suspect your resident has problem early in the rotation, you are probably correct. Up to 10% of residents encounter difficulties during their program. As a preceptor, your responsibility is to identify that the resident is in difficulty and take the appropriate steps.

The University of Ottawa has a tool, the Academic Support Process, to help preceptors support residents in difficulty. The tool provides a mechanism for identifying issues of concern and developing a plan to resolve the issues.

After completing this module, learners will be able to:

  • Recognize the signs of a resident in difficulty
  • Describe the necessary steps to take when a resident is in difficulty
  • Describe the resources available when a resident is in difficulty

Recognizing the signs

Just like a clinical problem, the first step is to define the difficulty and to develop a differential diagnosis. Often the causes of the concern are more complex than lack of knowledge or clinical skills and may include issues related to mental or physical health, relationships or even a mismatch between the resident's learning style and preceptor's teaching style.

Read "Phase 1: Learner with concerns" on Academic Support Process website.

The mnemonic SOAP (Subjective, Objective, Assessment, Plan) can be used to help analyze if a resident is having difficulty.

Read "Defining the problem" by Practical Prof, for a description of SOAP.

If you have identified a resident in difficulty, contact your Unit Program Director. The following diagram illustrate the chain of people who may be involved in supporting a learner in difficulty. You can find the name of the person who is currently appointed to the position and their contact information in the Department of Medicine Faculty Directory.

Faculty Directory

Taking the necessary steps

The Academic Support Plan website provides a series of tools to help you create and track a plan to assist the resident in need:

Read "Phase II: Support plan development"

Read "Phase III: Support plan implementation and tracking"

Read "Phase IV: Evaluation"

You can direct residents to this site and encourage them to create their own support plans using the Microsoft Word Templates.

Resources available

Your first point of contact should always be your Unit Program Director.

The RELAY team is a group of physicians who have received special training in working with residents in difficulty. There are members of the Relay team within each unit. Members of the team can be brought in for one-on-one supervision with the learner or alternatively they can be tasked with supervising the preceptor's other residents to free up the preceptors to do one-on-one with the learner in question. This is a service provided and funded through the Department of Family Medicine or the Faculty of Medicine. Contact your Unit Program Director if you require the services of the Relay team.

If you require assistance with completing a support plan, please contact Kim Rozon at: or 613-562-6335 ext 1610.


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