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Performance coaching for trainees - case study
Paediatric GP SHO
This case study is fictitious but based on CDU experience.
Dr JK had been working for three months in her second hospital post on the local GP scheme. At her mid-point appraisal she was told that she was not performing to the level that would have been expected from someone at her stage. Specifically she had problems with clinical decision-making and had difficulty prioritising her work, particularly when it was busy. She was erratic about asking for help - asking the registrar to make relatively minor decisions but not calling for help with her first lumbar puncture. Her record of attendance at educational events was poor and she was seen to stay late on the ward most evenings writing in the notes. None of the team knew her very well and the nurses thought her ineffective.
At her CDNA, Dr K revealed that she had recently broken up with her long term partner and she was unable to go home because of a dispute over the ownership of their house. She was having difficulty sleeping and felt tired and ill. She had lost confidence at work and was unable to concentrate. She therefore had to stay late in order to make sure she had done everything. Reports of her appraisals at her previous job in general medicine were very satisfactory and her previous consultant trainer in medicine was very surprised that she was having problems.
Dr K was advised to see her own GP who felt she had mild depression: as a result she was off work for 5 weeks. With the support of Occupational Health she came back to work part-time and arrangements were made for her close support and supervision.
Once Dr K was established back at work, the CDU coach met with her and her trainer to develop a performance improvement plan that focused on developing her confidence. She agreed that one of the SpR's should know her background and provide special support for her. By the end of her post Dr K was functioning well enough to pass the criteria for success that had been set. The progress review report was passed on to her next consultant with her consent and the CDU coach continued to monitor her progress until the mid-point appraisal when her performance was satisfactory and she was once again enjoying her job.
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