ZZZ Date
Purpose:
The purpose of the corrective action plan is to maximize the opportunity for resident success during their training period that is not performing as expected in one or more areas of the core competencies or EM Milestones. If and when specific deficiencies are noted or if there is a failure of the graded progressive skill development those deficiencies will be documented, discussed with the resident in question, and a plan will then be outlined with a time line and measurable goals against which the resident’s performance will be compared.
The experiential learning of residency training is a demanding process that is recognized as progressive skill development. Skill levels upon graduation from medical school and the beginning of residency training are different for each learner as are the individual learner trajectories and abilities to process information. During the training period however, competency based goals must be achieved (in a progressive manner) in order to be successfully promoted from one year to the next. It is understood that not all learners progress at the same level.
Background:
This plan is specific for Redacted, MD as it pertains to deficiencies identified early in his training period. Through continuous direct observation in the Emergency Department the Faculty have identified significant deficiencies that left uncorrected, will result in the failure of his promotion to the EM-2 year. He is operating at a level significantly below that of his peers in terms of his patient care, development of a coherent/cogent treatment plan, utilization management, recognition of acuity, significance of pathology, task execution, and time management.
He will be placed on Academic Remediation on ZZZ. It should be noted that his placement on Academic Remediation has the unanimous support of the entire OUDEM Faculty as a result of frequent direct observation of Dr. Redacted’s clinical performance and is documented further both below and will be reviewed in his mid-year Resident evaluation as well as Faculty clinical evaluations.
Directly Observed Competency Based Remediable Issues
Patient Care:
- Inability to interpret common diagnostic tests
- Inability to process and develop a differential diagnosis and treatment plan in a complicated medical patient
- Inability to multi-task at a level equal to his peers resulting in a mandated decreased level of responsibility by the Program Director (3 rooms max)
- Failure to recognize or understand (potential or actual) severe patient acuity
- Poor time management
Medical Knowledge:
- Remedial understanding of common clinical situations
- Failure to recognized and interpret pathology
Interpersonal and Communication Skills:
- Disorganized, incomplete, and inadequate explanations to Faculty during patient presentation
Systems Based Practice:
- Inability to identify proper disposition of a patient based on acuity. (Both ICU, floor, and discharge.)
- Poor resource utilization
Practice-Based Learning and Improvement:
- Significant difficulty when attempting to synthesize the medical literature and apply it to a specific clinical situation.
- Student level knowledge concerning the development of a treatment plan
- Very poor organization and task oriented/directed thinking.
Professionalism:
- The Faculty recognizes Dr. Redacted’s positive attitude and no significant deficiencies in Professionalism have been identified.
Implementation
- Regular meetings with Dr. Redacted (every 2-3 weeks) in which we discuss in detail each deficiency and identify a strategy to overcome that deficiency
- Dr. Redacted will work with each Faculty individually during a patient presentation with special attention to:
- Communication skills
- Improvement in receiving feedback and instruction
- Development of a treatment plan
- Mental flexibility in changing/altering a treatment plan should the clinical situation dictate
- Attention to detail
- Structured approach to each patient
- Regular request for Faculty feedback
- Dr. Redacted will shadow 3-4 shifts a month (in addition to his assigned clinical shifts the in the ED as long as these requirements comply with Duty Hours requirements) with senior residents in order to model his behavior, develop efficiency and improve his patient care.
Time line & Consequences of success/failure
- In our initial discussion the initial time line of 6 months was given (from ZZZ) for the attainment of the measurable goals
- Dr. Redacted understands that this time line is flexible
- Success: Corrective action is completed and Dr. Redacted will be promoted to the EM-2 year.
- Failure: Continuation of the EM-1 year and a re-examination and determination by the entire Faculty of deficiencies and a re-establishment of a new corrective action plan
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