Performance coaching for trainees - how the CDU can help

Personal coaching allows trainees to explore the issues and understand why difficulties have arisen and what they have to learn or change to get back on track.

The CDU coach works with the trainee's trainer and receives a written and verbal report from them before starting the coaching process with the trainee. Developing an effective plan to deal with any difficulties depends on real understanding of the reasons why difficulties have occurred, against the background of the doctor's previous experience and personality.

This assessment informs the subsequent performance improvement plan which is negotiated by the CDU coach with both the trainee and the trainer. The remedial training programme is taught by the trainer, supervised by the CDU coach and includes a formal progress review.

There are four stages:

• Career Development Needs Report (CDNR)
• Performance Improvement Plan (PIP)
• Learning and/or supervised remedial training
• Progress review
• CDU help flowchart

The Career Development Needs Report

The Career Development Needs Report (CDNR) normally consists of a confidential one-to-one 2-3 hr interview .The purpose of the needs assessment is to clarify the issues for the trainee that relate to their performance at work or their failure to pass exams, to explore these in the light of their previous experience and put them in the context of their personal and professional qualities. The information that is reviewed in the CDNR includes:

• in-depth exploration of personal and professional qualities in the light of their previous experience.
• psychometric tests such as the Myers-Briggs Type Inventory or the FIRO-B.
• CV, training and appraisal record containing information about assessments and feedback, including multisource feedback.
• report from trainer, including previous RITA assessments or Foundation programme competency assessments

The CDNR explores the individual's experience and professional development and can be helpful in identifying the reasons for any difficulty. Crucially it identifies the key personal perspectives and behaviours that have contributed to any area of under performance or failure to demonstrate competence and the reasons why these may have developed. This should help promote insight and self-awareness and there will be an opportunity for the trainee to reflect on the report before the next meeting to plan how to get back on track.

Performance Improvement Plan

The performance improvement plan (PIP) is based on the findings of the original career development needs report. The CDNR should provide a summary and identify specific areas or behaviours that individuals may need to change or focus on to improve their performance or demonstrate their competence. The performance improvement plan is negotiated with the trainee together with their trainer and attempts realistically to tackle the issues involved. Personal learning styles and preferences will be used to explore the best way for the trainee to address these and the trainer will provide information about local educational resources.

A range of options can be considered, including specific courses, other educational opportunities and more formal remedial training. If there is a need to provide a supernumerary remedial training placement, then the Postgraduate Dean will need to be approached. Robust arrangements for monitoring progress will be an integral part of the plan.

Learning and/or supervised remedial training

Learning will take place as planned. Any remedial training will have a named trainer supervised by a CDU coach. Progress will be monitored as planned.

The remedial trainer is likely to take a coaching approach and will increase opportunities for:

• close observation of specific behaviours
• constant detailed feedback
• opportunities to practice new behaviours
• detailed recording and careful planning.

In addition the trainee is likely to have to spend significant personal time reading and attending educational events and workshops. The trainee should take responsibility for ensuring that monitoring arrangements take place, such as an observation of their practice or questionnaires for multisource feedback.

Progress review

After an agreed interval the CDU coach, the trainer and the trainee will formally review progress using the results of the agreed monitoring procedure.

The CDU coach will provide a report which should provide clarity about whether the criteria for success of the Performance Improvement Plan have been met. This report can be used by the trainer to support the evidence provided for the next RITA panel but it should be clear that the responsibility for assessing overall clinical competence remains with the responsible trainer.

CDU help flowchart