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      A practical approach to mentoring students with repeated performance deficiencies

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          Abstract

          Background

          With the increasing use of competency-based evaluations we now have more and better ways to identify performance deficiencies in our learners. Yet the emphasis placed on identifying deficiencies appears to exceed that given to improving these deficiencies.

          Aims

          Here we describe the program at the University of Calgary for mentoring students with repeated performance deficiencies. We focus primarily on the key steps of mentoring and remediation, and establishing a program that provides consistency and accountability to this process.

          Conclusions

          A small cohort of trainees with persistent performance deficiencies may need intensive remediation to reach the expected level of performance. Ultimately, not all learners will be successful in their remediation, but we feel that it is the responsibility of training programs to provide mentorship and an organized approach to remediation in order to maximize the chances of successful remediation.

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          Most cited references13

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          Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

          To systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Medline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxiety, and burnout among U.S. and Canadian medical students. Searches used combinations of the Medical Subject Heading terms medical student and depression, depressive disorder major, depressive disorder, professional burnout, mental health, depersonalization, distress, anxiety, or emotional exhaustion. Reference lists of retrieved articles were inspected to identify relevant additional articles. Demographic information, instruments used, prevalence data on student distress, and statistically significant associations were abstracted. The search identified 40 articles on medical student psychological distress (i.e., depression, anxiety, burnout, and related mental health problems) that met the authors' criteria. No studies of burnout among medical students were identified. The studies suggest a high prevalence of depression and anxiety among medical students, with levels of overall psychological distress consistently higher than in the general population and age-matched peers by the later years of training. Overall, the studies suggest psychological distress may be higher among female students. Limited data were available regarding the causes of student distress and its impact on academic performance, dropout rates, and professional development. Medical school is a time of significant psychological distress for physicians-in-training. Currently available information is insufficient to draw firm conclusions on the causes and consequences of student distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency.
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            Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains.

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              A prospective analysis of stress and academic performance in the first two years of medical school.

              This study provides prospective, longitudinal data on the relationship between stress-related measures and academic performance during the first two years of medical school. First year medical students (n = 121) were surveyed prior to beginning classes (wave 1), and again 8 months later (wave 2). Personality variables predisposing to distress (optimism and trait anxiety), stress response (depression and state anxiety), and stress management strategies were assessed at wave 1 and wave 2. Pre-medical academic scores, and grades at the end of five assessment periods over the course of the first 2 years of medical school were also obtained. As expected, pre-medical-school academic performance strongly predicted performance in medical school. Academic performance before and during medical school was negatively related to reported stress levels. On bivariate correlations, there were numerous significant relationships between stress reported at waves 1 and 2, and medical school academic performance assessed after these measures. In addition there were modest negative correlations between self-reported coping strategies of 'humour' and 'wishful thinking', and consequent academic performance. However, the predictive value of stress and its management on prospective academic performance was much decreased once pre-medical-school performance was statistically controlled.
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                Author and article information

                Contributors
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central
                1472-6920
                2013
                19 April 2013
                : 13
                : 56
                Affiliations
                [1 ]Office of Undergraduate Medical Education, University of Calgary, Calgary, AB, Canada
                [2 ]Office of Equity and Teacher-Learner Relations, University of Calgary, Calgary, AB, Canada
                Article
                1472-6920-13-56
                10.1186/1472-6920-13-56
                3641019
                23597111
                a6bb75d5-3714-4fa3-a4b5-da2e753772ed
                Copyright © 2013 McLaughlin et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 August 2012
                : 11 April 2013
                Categories
                Correspondence

                Education
                Education

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