Managing Difficult Situations

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Despite the best planning and preparation, clinical educators are often faced with difficult situations to work through with their students. Managing the challenges of clinical supervision can provide the best opportunities for learning for both the educator and student.

Challenging behaviours can be defined as any behaviour, clinical performance or health status that is impacting on a student’s ability to meet the requirements of the placement, profession or workplace code of conduct (Australian Learning and Teaching Council, 2010). Examples of behaviour that a clinical educator may observe that demonstrate a student is experiencing difficulty include:

• Emotional problems including high anxiety or stress
• Difficulty linking theory to practice
• Challenging behaviours (i.e. dominating, shy/quiet, disengaged, disruptive etc)
• Lack of interest in clinical area of placement
• Poor communication skills (with staff or patients)
• Poor organisational, prioritisation and administrative skills
• Lack of self-direction
• Conflict with clinical educator
• Overconfidence

(Australian Learning & Teaching Council, 2010; Health Education and Training Institute, 2012; Queensland Occupational Therapy Fieldwork Collaborative, 2007).

The above behaviours should be addressed as soon as possible to prevent a crisis. Crisis may occur if there is a risk to patient safety or the wellbeing of the student or other staff members. The clinical educator should be aware that difficulties may arise due to many factors including:

• personal stress
• stress relating to other commitments (work, family, university deadlines)
• cultural conflict
• culture shock
• unclear expectations
• lack of confidence
• inadequate feedback regarding performance in previous placements
• limited clinical experience
• negative experience in previous clinical placement
• readiness for learning

(National Rural Health Students Network, 2011; Queensland Occupational Therapy Fieldwork Collaborative, 2007; Nemeth & McAllister, 2013).

Clinical educators must be aware of their own skills and limitations when addressing difficulties, and seek support from their line managers or university placement coordinator if they do not feel equipped to address the issues with the student. Most difficulties encountered by clinical educators can be defined as unsatisfactory or poor performance and can be managed early using the strategies to be discussed in this guide. However, circumstances may arise where a student is demonstrating unprofessional conduct, professional misconduct or notifiable conduct which requires the immediate attention of the university and possible suspension of the student. Notification may also need to be made to the professions regulatory agency e.g. Allied Health Practitioner Regulation Agency, as appropriate. It is recommended that clinical educators be familiar with relevant university supervisor fieldwork manuals and discipline specific requirements for reporting the behaviour.

(This document has been reproduced from Health Workforce Australia (2013), Enabling Clinical Supervision Skills)