Preventing Problem Learning Situations

Primary Prevention:

  1. Know the Family Medicine Department’s specific expectations for the course. Review these expectations with the student during your first meeting using the Learning Plan form.
  2. Make your expectations known to the student during the orientation. Inform the student of specific things they should be aware of – dress code, hours, and contact information.
  3. Determine what the student’s expectations and goals are and determine if mismatches exist between your goals and theirs. Schedule time during the fourth session to review the Learning Plan form and refine and reassess your goals and the student’s goals.
  4. Plan for preceptor-related issues that may have an impact on your teaching experience. These can include unanticipated personal events, schedule/financial changes or an unanticipated personality clash with your learner. If these issues prevent you from doing what you need to do in your practice or could seriously affect the student’s experience, consider declining the student for the quarter.

Secondary Prevention

  1. Maintain awareness that things can go wrong. Don’t ignore the early warning signs of difficult interactions.
  2. If a potential problem situation arises, institute an organized assessment of the situation. One such assessment method is the SOAP method.

Tertiary Prevention

  1. Seek help from course faculty if a significant problem arises with your learner.
  2. Don’t give the learner a passing grade if you do not think they have met the goals of the course.

Contact Information for Course Faculty

Amanda Kost, MD - Course Chair
akost@uw.edu, (206) 543-9425

Ivan Henson - Course Coordinator
famed@uw.edu

The SOAP Approach to Problem Interactions

  1. Subjective: What made you suspect a problem existed? What do others think of the student? Does a general pattern of behavior seem apparent? Ask the student how they feel things are going to see if they are aware a problem exists.
  2. Objective: Identify specific instances to document and to help you make your assessment and formulate a plan of action.
  3. Assessment: Analyze the above information and list the possible causes behind the problem
    • Cognitive: knowledge base/clinical skills less than expected? Learning disability? Communication difficulties? Lack of effort/interest?
    • Affective: Anxiety? Depression? Anger? Fear?
    • Valuative: Expects a certain level of work? Expects a certain grade? Does not value the preceptorship? Does not want to be at your clinic? Does not value your teaching? Holds principles that conflict with those of you or your patients?
    • Environmental: Hospital-care oriented? Not used to undifferentiated patients? Not time sensitive? Not patient-satisfaction oriented?
    • Medical: Illness? Substance Abuse? Depression or other mental illness?
  4. Plan: Should be based on your assessment, the impact of the situation on you, your practice and the learner. You can decide to:
    • Gather more data: observe and record, discuss with learner and contact the school
    • Intervene: give detailed behavior specific feedback, make specific recommendations for change and schedule a time for re-evaluation
    • Get help: get assistance from course faculty, ask for course faculty’s help in transferring the learner to a different learning environment if necessary.