WA News Letters Managing Poor Performance
Managing Poor Performance
Written by Prof Piers Yates
Tuesday, 29 November 2016

Dear Editor,

In his article Tough Love Saves Lives (October edition), Flt Lt Ray Werndly suggests a number close parallels in military pilot training that may have useful applications in medical training. Important attributes in both professions are flexible decision making, working though grey areas, and being able to recover situations when they go pear shaped.

These clearly have close parallels in the skills desired in our training, especially in the surgical specialties and anaesthetics. He also underlines the importance of identifying those that are not going to make it.

In postgraduate medicine, our training is still highly dependent on learning by experience and by observing the behaviour and professional standards of our supervisors. Factual knowledge and intelligence, like in aviation, is very important, and relatively easy to test, but what makes a good doctor is how we interact with our patients and make judgements that are not necessarily learned from a text book.

Some of these areas are difficult to assess, but in the future, the assessment of doctors will become more formalised and, again, we will probably follow the example of methods used in aviation assessment and training including simulation training, revalidation, psychological testing etc.

However, one of the biggest challenges for us in medicine is going to be how we manage poor performance when we do identify it, in order to correct or redirect trainees at the earliest opportunity. If we fail to be effective in this, then external bodies will become more and more involved in regulatory roles, which can only be detrimental to our profession.

Prof Piers Yates, Co-Head of Orthopaedic Surgery, Fiona Stanley Hospital