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Learning, judgement and workforce tensions impact failure to fail in a medical postgraduate setting: A supervisor perspective.

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  • المؤلفون: Daly M;Daly M; Lucas G; Lucas G; Wilkinson TJ; Wilkinson TJ
  • المصدر:
    Medical teacher [Med Teach] 2022 Oct; Vol. 44 (10), pp. 1092-1099. Date of Electronic Publication: 2022 Apr 18.
  • نوع النشر :
    Journal Article
  • اللغة:
    English
  • معلومة اضافية
    • المصدر:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 7909593 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1466-187X (Electronic) Linking ISSN: 0142159X NLM ISO Abbreviation: Med Teach Subsets: MEDLINE
    • بيانات النشر:
      Publication: London : Informa Healthcare
      Original Publication: London, Update Publications.
    • الموضوع:
      Attitude of Health Personnel* ; Clinical Competence*; Education, Medical, Graduate ; Humans ; Learning ; Workforce
    • نبذة مختصرة :
      Purpose: Medical training organisations have a duty to prepare medical graduates for future safe, competent practice. Decisions about underperformance are high stakes at the postgraduate level and failure to fail can occur. We aimed to explore this concept from a systems and supervisor perspective.
      Method: Supervisors of specialist physician trainees were invited to provide written feedback on failure to fail as part of a broader anonymous supervisor survey. They were provided with a trigger statement and responded in free-text format. A deductive content analysis was undertaken through the lenses of supervisor and institution.
      Results: Of 663 supervisors who responded to the broader survey, 373 (56%) provided feedback on the failure to fail trigger statement. Analyses indicated an interplay between trainee and supervisor characteristics, and broader system elements. System elements that contributed to failure to fail trainees included lack of longitudinal monitoring and quality of assessment information. Supervisor characteristics included confident, conflicted and avoidant behaviours towards underperforming trainees.
      Conclusions: Individual and system challenges that contributed to failure to fail were identified in this study, and we propose a three-way tension among learning, judgement and workforce. Three potential mitigation strategies have been identified to reduce failure to fail, namely a stage-based approach to remediation, faculty development in supervisory skills and improved assessment-for-learning processes.
    • Contributed Indexing:
      Keywords: Failure to fail; medical education; postgraduate training; supervisor
    • الموضوع:
      Date Created: 20220418 Date Completed: 20221010 Latest Revision: 20221018
    • الموضوع:
      20221213
    • الرقم المعرف:
      10.1080/0142159X.2022.2058385
    • الرقم المعرف:
      35430929