Applying your clinical skills to students and trainees in academic difficulty.

BACKGROUND: When students and trainees in difficulty present late, there are often signs in their history that suggest that earlier identification and intervention might have been possible. Clinical supervisors may have been reluctant to explore issues with them, perhaps because they felt that it was not their role to do so, or that they may not have the necessary skills or perhaps because of the concern of 'opening a can of worms' that they would not be able to address. INNOVATION: In this article we discuss the importance of early identification and intervention, and draw parallels between the skills required to manage students and trainees in difficulty, and those used daily in identifying and exploring issues with patients. This is based on a combined experience of over 30 years in helping students and trainees in difficulty, and in training and mentoring others to do so. Following this medical model, we highlight straightforward methods for: identifying those in difficulty; making a 'diagnosis'; providing simple interventions; and knowing when and how to refer on. We discuss issues around record keeping, confidentiality and ongoing management, with particular reference to the aspects of the doctor-patient interaction that do not transfer to the supervisor-trainee relationship. © Blackwell Publishing Ltd 2010.