1. 2+2=9 Resident Remediation Patrick Bridgeman, PharmD Clinical Assistant Professor Ernest Mario School of Pharmacy Residency Program Director PGY-2 Emergency Medicine Pharmacy Robert Wood Johnson University Hospital

2. Learning Objectives Select appropriate behaviors to correct with a resident remediation plan List activities for a resident remediation plan

3. Resident “Case” One of your residents is currently on an internal medicine rotation. You have received negative feedback regarding their performance from the preceptor. The Preceptor would like you to consider a remediation plan. What is the best course of action?

4. Reasons for Remediation Poorly elaborated/disseminated Policy Performance issues – Clinical knowledge deficits – Communications skills deficits – Inability to be introspective Mentoring/Learning Style Conflicts – Communication style – Personality types Introvert vs extrovert, etc.

5. Appropriate Behaviors for Remediation Proper assessment – Tie to residency competencies and requirements – External validation Target behaviors – Performance Anxiety High Stress situation, presenting patients – Coping deficits – Work/Life balance – Cultural differences – Communication style

6. Resident “Case” Upon further investigation with the preceptor you find that the resident is unable to appropriately present patients to the preceptor (eg lack of information, inappropriate plan) During discussion with the resident you find they report they are having difficulty in these situations as well.

7. Tie Behavior to Competency Competency : – R1.1.1 Interact effectively with health care teams to manage patients’ medication therapy – R1.1.5 Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans Behavior: – R1.1.1 Difficulty in presenting patients to preceptor – R1.1.5 Plans lack specific end points

8. Implementing a Remediation Plan Clear measurable outcomes Length of time Consequences

9. Measureable Outcomes R1.1.1 – Implement SBAR format – Present 5 situations in SBAR format daily to preceptor R1.1.5 – Daily written SOAP note for preceptor and program director to review

10. Length of time Can vary based on level of remediation – 2 weeks to a month

11. Resident “Case” You have reviewed the remediation plan with the resident. The resident is in agreement and would like to continue with the remediation plan.

12. Obtaining feedback Important to name responsible parties in remediation plan – Preceptor – Program director – Resident Verbal or written Direct observation

13. Consequences Unsuccessful at completing remediation – Consider further remediation – Suspension – Dismissal Successful remediation – Great! – Continue to monitor and follow up

14. 2+2=9 Resident Remediation Patrick Bridgeman, PharmD Clinical Assistant Professor Ernest Mario School of Pharmacy Residency Program Director PGY-2 Emergency Medicine Pharmacy Robert Wood Johnson University Hospital