The Clinical Problem Solvers Episode 398: WDx #36: How to Approach a “Struggling” Learner
May 29, 2025
Dr. Julia Armendariz, a hospitalist and clinician educator at Stanford, shares her expertise on guiding struggling learners in medical education. She emphasizes the power of low-inference statements in feedback, helping to pinpoint underlying issues. The conversation highlights the need for empathy and clear communication, advocating for a compassionate approach. Julia also discusses the challenges of delivering feedback amidst emotional complexities, revealing strategies to support both high and low insight learners effectively.
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High vs Low Inference Statements
- We tend to interpret struggling learner behaviors emotionally with high-inference statements.
- Shifting focus to factual, low-inference statements about observable behaviors enables clearer, unbiased feedback.
Start with Observations and Questions
- Use factual observations to start feedback conversations, e.g., "I noticed you ordered pain meds but didn't escalate signs of sepsis."
- Invite learners to explain behaviors to identify underlying barriers.
Four Domains of Learner Challenges
- Underlying problems in struggling learners fall into four buckets: medical knowledge, organization, communication, and professionalism.
- Professionalism is a diagnosis of exclusion after ruling out other issues.
