Describing Failure in a Clinical Clerkship: Implications for Identification, Assessment and Remediation for Struggling Learners

Excerpt

We thank Dr. Wang and colleagues for their thoughtful reflections on our paper. We agree that many struggling learners appear inefficient compared to their peers as they undertake routine clinical care tasks. In our analysis, the critical deficiency “inefficiency” was present in 8 (19%) of our 43 students who failed the medicine clerkship.1 The lower frequency of this critical deficiency in our sample as compared to the frequency of difficulties with efficiency/organization noted by residency program directors2 may reflect, as they suggest, that efficiency is not yet expected from medical students. It is also possible that behaviors one might interpret as inefficient are actually represented in other domains and coded in our study as deficiencies such as “late,” “failure to complete course work,” or even perhaps “disinterested” or “inadequate documentation.” Perhaps one could even attribute NBME Subject Exam failure to inefficient or disorganized study habits. …