Saturday, June 30, 2012

GNIE: Anatomy of a clinical failure

The news is out. There is a couple of my classmates who failed at clinical this round. They are likely to go through the appeal process. In respect for their confidentiality, I would not share about the details. However, I think it would be useful for my readers heading to the GNIE program to recognize the warning signs.

From what I've gathered to-date: the signs were there for those involved.
  • Being supervised closely by the CI even on the latter 1/2 of their clinical period.
  • Long replies from the CI to their anecdotal notes, with specific examples of how/why they were not meeting the competencies. [Note: My clinical group caught up to this risk factor quite quickly because sometimes we discussed the "confidential" feedback we got from the CI. We joked about how "No news is good news, and short replies are good replies."]
  • The CI's long replies have repeated reminders of the same/similar problem(s) again and again because of a lack of acknowledgement by the student(s) of the issue.
  • Being made to sign a "contract for learning" in the latter 1/2 of the clinical period. This is a risk factor, but it does not seal one's fate because there is someone who passed despite the "contract".

One of those who failed is my friend, so I am not happy for her situation. She sought my help only after her 2nd last week of clinical, i.e. leaving only the final week (i.e. last 2 clinical days) to show any improvement. I helped her with her anecdotal notes for that 2nd last week based on information she supplied me. She said that she doesn't know what the CI wanted of her, so I asked her if anything specific happened, to which she shared some issues but denied anything else of significance. [On hindsight: unless the person involved is able -- i.e. has enough awareness, i.e. not stuck in the blind spots -- and willing to share the whole truth, it is very hard for others to help them successfully.] It was only later, after her final clinical week and just the day before the failure was announced, that she emailed me the CI's reply to her (dated before her final clinical week) to the anecdotal notes that I had helped her prepare. The CI's reply revealed that my friend had omitted mentioning to me some significant issues that had happened. [Again on hindsight: Perhaps I wasn't culturally sensitive enough or my EQ wasn't good enough to pick up earlier that my friend had omitted telling me some stuff.]
This is what I replied my friend after reading the CI's reply: I am emailing this reply only because of the restrictions we face regarding such discussion at the moment. My 2 cents: I can only say that I wish you had shown me this earlier -- like before your last 2 days of clinical, so that I could advise you accordingly. It is too late now to do anything on the "physical world" about your last 2 days. Do you still have any outstanding tasks related to clinical left to do (e.g. self-evaluation, etc)? At this moment, all you can do is just hang in there and hope that your final days were ok. I am sorry, I am not so optimistic after reading this document, nevertheless you have a thread of hope -- "hang in there".
From what I've heard from the grapevine, the other person who failed also had blind spotsAfter the failure was announced, she showed her anecdotal notes and the CI's replies to another classmate. It was only when the other classmate advised her that she realized her blind spots. 

So my 2 cents to those asking for help to pass: 
  • Please ask for help ASAP (as soon as possible).
  • If in doubt, ask for help. [That is what my clinical group members did. From there, if we thought that anyone is at risk, we would help check that person's work, supported him/her and covered each other's asses. I, too, survived thanks to my clinical group members' support.] 
  • Be totally open about what happened. It is not a time to "save face".

Now is past the stage of taking corrective action at clinical. Now is the stage of appeal. Strategy dictates that the focus now should be on how to snare another chance -- hopefully one with the minimal possible impact on my friend's GNIE progression.

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