G. Bourgeois-Law is clinical associate professor, Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, and PhD candidate, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-4726-3663. P.W. Teunissen is professor of medical education, School of Health Professions Education, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands, and gynecologist, Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; ORCID: https://orcid.org/0000-0002-0930-0048. L. Varpio is professor, Department of Medicine, and associate director of research, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: https://orcid.org/0000-0002-1412-4341. G. Regehr is professor, Department of Surgery, and associate director for research, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0002- 3144-331.
Acad Med. 2019 Nov;94(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 58th Annual Research in Medical Education Sessions):S36-S41. doi: 10.1097/ACM.0000000000002896.
The data for this paper were collected as part of a larger project exploring how the medical profession conceptualizes the task of supporting physicians struggling with clinical competency issues. In this paper, the authors focus on a topic that has been absent in the literature thus far-how physicians requiring remediation are perceived by those responsible for organizing remediation and by their peers in general.
Using a constructivist grounded theory approach, the authors conducted semistructured interviews with 17 remediation stakeholders across Canada. Given that in Canada health is a provincial responsibility, the authors purposively sampled stakeholders from across provincial and language borders and across the full range of organizations that could be considered as participating in the remediation of practicing physicians.
Interviewees expressed mixed, sometimes contradictory, emotions toward and perceptions of physicians requiring remediation. They also noted that their colleagues, including physicians in training, were not always sympathetic to their struggling peers.
The medical profession's attitude toward those who struggle with clinical competency-as individuals and as a whole-is ambivalent at best. This ambivalence grows out of psychological and cultural factors and may be an undiscussed factor in the profession's struggle to deal adequately with underperforming members. To contend with the challenge of remediating practicing physicians, the profession needs to address this ambivalence and its underlying causes.
本文的数据是作为一个更大的项目的一部分收集的，该项目旨在探讨医学专业人员如何理解支持临床能力有问题的医生的任务。在本文中，作者关注的是一个迄今为止文献中尚未涉及的主题——需要补救的医生是如何被负责组织补救的人员以及一般来说他们的同行所感知的。
作者采用建构主义扎根理论方法，对加拿大各地的 17 名补救利益相关者进行了半结构化访谈。由于在加拿大，卫生是省级责任，作者有意从省级和语言边界以及可以被认为参与执业医生补救的各种组织中选择利益相关者进行抽样。
受访者对需要补救的医生表示出混合的、有时甚至相互矛盾的情绪和看法。他们还指出，他们的同事，包括在培训中的医生，并不总是对他们挣扎中的同行表示同情。
医学专业对那些在临床能力方面挣扎的个体和整体的态度是矛盾的。这种矛盾源于心理和文化因素，可能是该专业在努力适当应对表现不佳的成员方面未被讨论的一个因素。为了应对对执业医生进行补救的挑战，该专业需要解决这种矛盾及其潜在原因。
