Dudek Nancy L, Marks Meridith B, Regehr Glenn
505 Smyth Road, Room 1105D, Ottawa, Ontario, Canada, K1H 8M2.
Acad Med. 2005 Oct;80(10 Suppl):S84-7. doi: 10.1097/00001888-200510001-00023.
Clinical supervisors often do not fail students and residents even though they have judged their performance to be unsatisfactory. This study explored the factors identified by supervisors that affect their willingness to report poor clinical performance when completing In-Training Evaluation Reports (ITERs).
Semistructured interviews with 21 clinical supervisors at the University of Ottawa were conducted and qualitatively analyzed.
Participants identified four major areas of the evaluation process that act as barriers to reporting a trainee who has performed poorly: (1) lack of documentation, (2) lack of knowledge of what to specifically document, (3) anticipating an appeal process and (4) lack of remediation options.
The study provides insight as to why supervisors fail to fail the poorly performing student and resident. It also offers suggestions of how to support supervisors, increasing the likelihood that they will provide a valid ITER when faced with an underachieving trainee.
临床督导员常常不会判定学生和住院医师不合格，即便他们认为其表现不尽人意。本研究探讨了督导员在填写培训期间评估报告（ITER）时所确定的、影响其报告临床不佳表现意愿的因素。
对渥太华大学的21名临床督导员进行了半结构化访谈并进行定性分析。
参与者确定了评估过程中的四个主要领域，这些领域成为报告表现不佳的实习生的障碍：（1）缺乏文件记录，（2）不知道具体记录什么，（3）预期会有上诉程序，（4）缺乏补救方案。
该研究揭示了督导员不判定表现不佳的学生和住院医师不合格的原因。它还提供了如何支持督导员的建议，增加了他们在面对表现未达预期的实习生时提供有效ITER的可能性。
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