Bad preceptors/interns?

[ParamedicStudent]

Does anyone have experience or heard stories about bad preceptors? Why is it and what made them bad?
On the other side of the spectrum, what about bad interns?

Thanks, in advance. Would like to hear some stories.

 

[TXmed]

Bad preceptor stories almost always involve preceptors that try to be too hard on new trainees or are too in your face. Usually end with the precepters trying to prove that the trainee isnt ready.

I would almost always get the trainees AFTER they were failed by the preceptors and the trainees just needed 1-2 observer shifts because nobody ever really SHOWED them how to put all their knowledge together. The previous preceptor would take the stance "best way to learn is to do it" then when the trainees didnt perform the skill perfectly the preceptor would lose patience and put a ton of pressure on the trainees.

As far as poor trainees ive had. Just ones with poor work ethic, always 5 min late, always on their phone etc.

 

[RocketMedic]

Bad trainee I once had at EMSA: boots up, feet up on the cot, bs-ing on what I suspect was an adult website instead of participating in call review.

 

[hometownmedic5]

My partner(good cop) and I(bad cop) had an intern last week. We got a call right at shift change so we weren't able to have much in the way of a preliminary conversation. After we did that call(BLS nonsense), we were driving back to the station and my partner asked the intern to list his clinical deficiencies as he saw them. He answered that he was having trouble adjusting to the jelco style IVs as he was used to the push button autoguards. My partner said "no, clinical deficiencies. Where are your knowledge gaps? What aren't you good at treating? What concepts do you need more understanding of"? He said just the IVs. Mind you this was his third shift riding as a medic intern.

Enter bad cop. I said to him "so in the whole grand scheme of paramedicine, you as a third shift intern have it all figured out and are an expert paramedic who's only problem is a relatively minor adjustment to a different piece of equipment"? I was trying to say it in such a way as to lead him to the correct answer, but I must have had an odd lilt to my voice because he evidently thought I was in awe of how he managed to accumulate such an extensive knowledge base so early in his career. Over the course of the day, we had several teachable moments, all of which were ignored by the best damn medic intern ever to show up on an ambulance. That is the worst type of intern you can be. Not knowing something is fine; thinking you have nothing left to learn is not, especially when you really dont know a damn thing yet.

The worst mentor on the other hand is someone who expects their trainee to have the same level of experience and competetence that they do. The person that forgot that when they showed up for their first day, they also didn't have any idea what they were doing. School(EMT or Medic) doesn't teach you how to be an expert provider. That takes years of doing the job. If you cant find a way to download your experience and knowledge into your trainee without being abusive about it, you shouldn't be involved in training/precepting/mentoring.

 

[hometownmedic5]

double post

 

[VentMonkey]

When I first began precepting I gave out tests, asked the interns where they were, and where they wanted to be in week 1, 2, 3, etc.

As time went on, and they gave me intern, and trainee one after another I saw more that cared less and less about their training process, or at least didn't seem to take it as seriously as I had. There were a handful of good eggs that I could quite literally count on one hand, but the rest were basically @hometownmedic5's intern.

Obviously, I quickly grew jaded, and really lost my desire to impart any type of knowledge on the next generation of would-be EMT's and medics. I saw (and still see) a lot of "fluff". That is, a lot of "I would love to be like so, and so..." followed by absolutely zero follow through, or commitment.

I'd finally accepted I am but an odd duck in a sea full of soon-to-be superheroes. Since resigning my status as a preceptor I am so much happier. I still keep in touch with some of the interns I had the most fun with, but other than that I have no real regrets.

As far as being labeled a "bad preceptor", and having interns I've failed, or refused to put my name behind only to have the next preceptor coast said intern through? Meh, I also have zero regrets about this, especially since many of these interns have either proven to be problematic in the long run, and/ or have lasted all but a hot minute.

But hey? Butts in the seat, right?...

 

[harold1981]

I´ve seen preceptors that weren´t ready yet to do the job and end up compensating a lack of knowledge and experience with an attitude towards their interns. If you want to create a safe learning environment, you´ve got to be comfortable in your provider role first, and know how to be a guide when your student needs one. Generally I was taught to show and explain first, then allow to do under supervision and provide guidance through the process of becoming independent. Self-confidence and the ability to self-reflect have to grow side by side. After all, the learning will continue for years after a trainee goes solo and as a perceptor you are only building a solid base for him to provide safe treatment during that process. I agree that the efforts and attitude that the trainee shows will determine how much effort is going to be put in to prepare him for the job.
I too have seen quite a few fellows with a poor attitude come and go. Some of them just couldn´t care less, other would come in with a lack of insight and unable to apply their knowledge the right way at the right time. And a third group would come in, like others have mentioned, with the attitude that they could fly before learning how to walk, so to say ,,I´ll challenge you to prove how good I am´´. Trainees here are already employees on probation when they start their training.

I once had a trainee tell an old lady with a hip fracture: ,,If I were you, I would pray to God and ask him to take me. Life must be hard when you are so old.´´ I already knew that this dude missed a few screws in his head, but I still couldn´t believe my ears. It was the last call that I did with him and two weeks later he was fired after he was laughing at the size of a female patient´s breasts!

 

[RocketMedic]

That's....well, an interesting way to treat your patients