Early Identification of At-Risk Students in the Clinical Learning Environment: A Novel and Preventative Coaching Approach

UME involves rigorous training, and students vary in achieving levels of clinical competency; some struggle more than others and may require remediation. Previously an underutilized component of UME, coaching-based remediation programs have become more prevalent, with increasing interest in strategies to remediate struggling learners. Current literature focuses on remediating students who have already failed, with little discussed about at-risk learners - individuals who have yet to fail but are at risk for not meeting expectations based on prior clinical performance. Few, if any, formal coaching curricula exist to aid medical educators in early identification and determination of deficits in at-risk learners. When at-risk learners are identified earlier, clerkship or subinternship directors must still balance early identification and extra support with the risk of the learner feeling stigmatized or pre-judged. Even when learners are identified early and accept help, finding appropriate coaching resources during a clerkship or subinternship can be difficult.

Fortunately, there are tangible strategies medical educators can utilize to achieve early recognition and diagnosis of at-risk learners, develop learner buy-in, and ultimately implement high-yield interventions during clinical rotations. Our workshop uses didactic and case-based discussion to demonstrate time-efficient and practical approaches to early identification and intervention for at-risk medical students during their clinical rotations, including real-time approaches for both short-term and long-term coaching for course directors and other UME leadership. Participants will leave with strategies for identification and coaching, sample coaching plans, and an overview of the program created and implemented at our institution.