The failure to fail underperforming trainees in health professions education: A BEME systematic review: BEME Guide No. 42

Yepes-Rios, Monica; Dudek, Nancy; Duboyce, Rita L.; Curtis, Jerri; Allard, Rhonda J.; Varpio, Lara

doi:10.1080/0142159x.2016.1215414

Cited by 149 publications

(142 citation statements)

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“…This theory encompasses that a student's ultimate behaviour is influenced by intentions and beliefs about the behaviour and its outcomes, the subjective norm, and the perceived behavioural control. Another (Howe et al 2010) Stress the effect of students' unprofessional behaviour on future patient-safety (Howe et al 2010;Yepes-Rios et al 2016;Wong et al 2017) Emphasize role modeling of responding to unprofessionalism to educators (Rougas et al 2015) Inform teachers about policies (Rougas et al 2015) Offer the possibility to educators to discuss their experiences with colleagues and get mutual support (e.g. in teacher communities The student displays an accidental professionalism lapse and is capable to prevent future professionalism lapses with help from regular teachers in the medical curriculum.…”

Section: Explore and Understandmentioning

confidence: 99%

“…Although medical educators observe unprofessional behaviour in up to 20% of all students, they only report 3-5% (Papadakis et al 2005;Mak-van der Vossen et al 2014). This discrepancy reflects the difficulty in evaluating professionalism, and is often denominated as the 'failure to fail' phenomenon (Yepes-Rios et al 2016). Probable reasons for the latter are: a lack of conceptual clarity about (un)professionalism in medical school, concern for the subjectivity of one's judgment, fear of harming a student's reputation, lack of appropriate faculty development, and uncertainty about the remediation process and its outcomes (Ziring et al 2018).…”

Section: Introductionmentioning

confidence: 99%

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How to identify, address and report students’ unprofessional behaviour in medical school

et al. 2019

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This AMEE guide provides a research overview of the identification of, and responding to unprofessional behaviour in medical students. It is directed towards medical educators in preclinical and clinical undergraduate medical education. It aims to describe, clarify and categorize different types of unprofessional behaviours, highlighting students' unprofessional behaviour profiles and what they mean for further guidance. This facilitates identification, addressing, reporting and remediation of different types of unprofessional behaviour in different types of students in undergraduate medical education. Professionalism, professional behaviour and professional identity formation are three different viewpoints in medical education and research. Teaching and assessing professionalism, promoting professional identity formation, is the positive approach. An inevitable consequence is that teachers sometimes are confronted with unprofessional behaviour. When this happens, a complementary approach is needed. How to effectively respond to unprofessional behaviour deserves our attention, owing to the amount of time, effort and resources spent by teachers in managing unprofessional behaviour of medical students. Clinical and medical educators find it hard to address unprofessional behaviour and turn toward refraining from handling it, thus leading to the 'failure to fail' phenomenon. Finding the ways to describe and categorize observed unprofessional behaviour of students encourages teachers to take the appropriate actions. . She received her MD in 1986, and completed residency training in general practice at the University of Amsterdam in 1990. Marianne worked in general practice for 15 years, combining this work with teaching clerks in the workplace, and from 2001 with other educational activities at the Faculty of Medicine at the VU University. From 2010 onwards, she has been coordinating the educational theme 'Professional behaviour' at the school. Recently, Marianne received her PhD with distinction. Her research explores how educators and peer students perceive and respond to unprofessional behaviours of medical students.Arianne Teherani PhD, is a Professor of role in which she leads design, development, and policy for evaluation of the school's curriculum and programs. Arianne's main research interests are in the areas of professionalism, professional identity formation, and equity in medical education. She has led studies aimed at identification and remediation of unprofessional behaviours, the role of clinical education in shaping the professional identity of learners and teachers, and the role of assessment and learning environment practices in perpetuating educational disparities and interventions aimed at creating equity during medical school. . His current medical education research focuses on generic aspects of (post)graduate training, and on intensive care medicine specifically, including the supervision of national and international PhD students. In addition he performs research in the fields of organ donatio...

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Section: Explore and Understandmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How to identify, address and report students’ unprofessional behaviour in medical school

et al. 2019

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“…Trainers are known to ‘fail to fail’ and this may be particularly so when cases and settings are not standardisable 28. By acknowledging that learning happens when trainees are stretched and that supportively critical feedback is used for development, the culture of assessment in training might be realigned.…”

Section: How Will We Know That They Can Do What They Have To Do?mentioning

confidence: 99%

How do we educate the next generation of emergency physicians: RCEM 50

et al. 2018

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“…When difficulties are not addressed as soon as they are detected, undue delays might occur before remediation and closer follow-up can take place 8,9. In certain cases, learners’ difficulties may in fact never be addressed, which may eventually allow less than fully competent trainees to be promoted to independent practice 10–12…”

Section: Introductionmentioning

confidence: 99%

Is there a way for clinical teachers to assist struggling learners? A synthetic review of the literature

Boileau¹,

St‐Onge²,

Audétat³

2017

AMEP

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Struggling medical trainees pose a challenge to clinical teachers, since these learners warrant closer supervision that is time-consuming and competes with time spent on patient care. Clinical teachers’ perception that they are ill equipped to address learners’ difficulties efficiently may lead to delays or even lack of remediation for these learners. Because of the paucity of evidence to guide best practices in remediation, the best approach to guide clinical teachers in the field remains to be established. We aimed to present a synthetic review of the empirical evidence and theory that may guide clinical teachers in their daily task of supervising struggling learners, reviewing current knowledge on the challenges and solutions that have been identified and explored. A computerized literature search was performed using Medline, Embase, Education Resources Information Center, and Education Source, after which final articles were selected based on relevance. The literature reviewed provided best evidence for clinical teachers to address learners’ difficulties, which is presented in the order of the four steps inherent to the clinical approach: 1) detecting a problem based on a subjective impression, 2) gathering and documenting objective data, 3) assessing data to make a diagnosis, and 4) planning remediation. A synthesized classification of pedagogical diagnoses is also presented. This review provides an outline of practical recommendations regarding the supervision and management of struggling learners up to the remediation phase. Our findings suggest that future research and faculty development endeavors should aim to operationalize remediation strategies further in response to specific diagnoses, and to make these processes more accessible to clinical teachers in the field.

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The failure to fail underperforming trainees in health professions education: A BEME systematic review: BEME Guide No. 42

Cited by 149 publications

References 32 publications

How to identify, address and report students’ unprofessional behaviour in medical school

How to identify, address and report students’ unprofessional behaviour in medical school

How do we educate the next generation of emergency physicians: RCEM 50

Is there a way for clinical teachers to assist struggling learners? A synthetic review of the literature

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