Crafting Supports for the Disorganized Resident

09-11-2023 09:55

In medical training time is a precious commodity for learners. Competing tasks of patient care, learning, administrative duties, self-care all require a great deal of time. This is often compounded by the requirement in different systems with different rules on a regular basis, depending on clinical rotations. Residents who struggle with organization experience frustration at minimum and often burnout. Having a protocol for early identification of residents who struggle with organization allows training programs to teach strategies early on to mitigate the cascade of problems that can occur as a result of disorganization. This discussion will provide attendees with a list of key warning signs and behaviors that often indicate a learner is struggling with disorganization. The impact of how teaching key strategies for improving organization influences milestone scores will be discussed. In addition, attendees will practice lean systems strategies to help learners improve organization.

The daily life of a medical trainee requires incredible amounts of multitasking and organization. However, it is not uncommon for trainees to exclaim that they feel like they are “drinking from a fire hose” with the volume of tasks they are required to manage. In addition, recent medical learners have not had the same exposure to “true medical practice” due to the Covid pandemic. The TMS Collaborative (2021) and Papapanou et al. (2022) independently found medical learners during Covid received a reduction in quality of teaching and decreased exposure to hands on experiences. This deficit in training has also resulted in residents not having the organizational skills to manage this workload.  

However, the skills of organization is vital to the success of the Family Medicine Physician. Organizational Skills are needed to successfully meet Patient Care, Systems-Based Practice, Practice-Based Learning and Improvement, Professionalism, and Interpersonal and Communication Skills Milestones. Not intervening when an organization deficit is recognized will likely result in a problematic training course for a learner and possibly patient safety concerns.  

Guerrasio (2018) recommends early identification and intervention for medical learners. Clearly identifying warning signs and behaviors that indicate difficulty with organization is key. It is also important that Family Medicine Faculty utilize the entire team including: program coordinators, clerks, nurses, and outside attendings to provide input on resident performance and organization. While collecting information and considering deficits faculty must be mindful of how bias can influence assessment, particularly for trainees that have identities that are different from faculty (McClintock, Fainstad, Jauregui, & Yarris, 2021). After identifying residents with organization difficulties faculty should take a solutions-based approach to education and intervention.

Author(s):Amber Cadick
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