The Problem Learner
by Lisa M. Vaughn, Raymond C. Baker and Thomas G. DeWitt

Giving difficult feedback is never easy, yet working in academic medicine it is something that we all must face at some point. This article describes one method for addressing the “problem learner”.

A couple questions to stimulate discussion:

  1. When giving difficult feedback to a “problem learner” have you used this S-T-P method, or a similar framework, to provide structure to the feedback? What approach, if any, has worked well for you?
  2. The article specifies 4 classes of problem learners (affective, cognitive, structural, interpersonal); Is this method suitable and/or appropriate for each class? Is this method appropriate for giving feedback to peers? To superiors?
  3. At what point is a “problem learner” a true problem vs. a different approach to learning medicine? Does this really vary by specialty?
  4. While the S-T-P method appears to have good “face validity”, do you think it is possible to validate this approach with outcome measurements?

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