The case of the entitled resident: A composite case study of a resident performance problem syndrome with interdisciplinary commentary.

Background: Residents with performance problems create substantial burden on programs and institutions. Understanding the nature and quality of performance problems can help in learning to address performance problems. Aim: We sought to illuminate the effects of resident performance problems and the...

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Published in:Medical Teacher Vol. 34; no. 12; pp. 1024 - 1033
Format: research Journal Article
Published: Taylor & Francis Ltd Dec2012
Online Access:View this record in EBSCOhost
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      dt: Dec2012
      vid: 34
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.3109/0142159X.2012.719654
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        atl: The case of the entitled resident: A composite case study of a resident performance problem syndrome with interdisciplinary commentary.
      aug:
      sug:
        subj:
          Interns and Residents
          Clinical Competence
          Quality of Health Care
          Human
          Massachusetts
          Case Studies
          Interviews
          Faculty, Medical
          Interprofessional Relations
          Narratives
          Counseling
          Student-Patient Relations
          Multidisciplinary Care Team
      ab: Background: Residents with performance problems create substantial burden on programs and institutions. Understanding the nature and quality of performance problems can help in learning to address performance problems. Aim: We sought to illuminate the effects of resident performance problems and the potential solutions for those problems from the perspectives of people with various roles in health care. Methods: We created a composite portrait from several residents who demonstrated a cluster of common performance characteristics and whose chronic or serious maladaptive behavior and response to situations created problems for themselves, for their clinical colleagues, and for faculty of their residency program. The composite was derived from in-depth interviews of program directors and review of resident records. We solicited practitioners from multiple fields to respond to the portrait by answering a series of questions about severity, prognosis, and how and whether one could reliably remediate a person with these performance characteristics. We present their perspectives in a manner borrowed from the New England Journal of Medicine's 'Case Records of the Massachusetts General Hospital.' Results: We created a composite portrait of a resident whose behavior suggested he felt entitled to benefits his peers were not entitled to. Experts reflecting on his behavior varied in their opinion about the effect the resident would have on the health care system. They suggested approaches to remediation that required substantial time and effort from the faculty. Conclusion: Programs must balance the needs of individual residents to adjust their behaviors with the needs of the health care system and other people within it.
      pubtype: Academic Journal
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        research
        Journal Article
      ougenre: Article
    language: English
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