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MEdIC Series: Case of the Failure to Fail – Expert Review and Curated Community Commentary


failure to fail MEdIC SeriesThe Case of the Failure to Fail outlined a scenario of an attending emergency physician who was frustrated with the ingrained “failure to fail” culture amongst his colleagues when faced with a resident who had significantly underperformed throughout his emergency medicine rotation.

This month, the MEdIC team (Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji, and Brent Thoma), hosted a discussion around this case with insights from the ALiEM community. We are proud to present to you the curated community commentary and our expert opinions. Thank-you to all participants for contributing to the very rich discussions surrounding this case!

This follow-up post includes

  • Responses from our solicited experts:
    • Dr. Nancy Dudek is an Associate Professor in the Faculty of Medicine at the University of Ottawa and Fellow of the Royal College of Physicians and Surgeons of Canada in the specialty of Physical Medicine and Rehabilitation. She focuses her clinical practice on Amputee Rehabilitation, Prosthetics and Orthotics. Academically, her work on the assessment of medical students and residents in the workplace has been recognized with numerous grants, publications and awards. Dr. Dudek currently works as a Clinician Educator for the Royal College of Physicians and Surgeons of Canada focusing on improving workplace based assessment.
    • Dr. Jessica Trier (@jesstrier) is an Assistant Professor in the Department of Physical Medicine and Rehabilitation at Queen’s University, with a clinical practice in acquired brain injury rehabilitation and electrodiagnosis. She is the Competency-Based Medical Education lead for the PM&R postgraduate training program at Queen’s University, and her scholarly interests include feedback in medical education, and the relationship between teachers and learners.
    • Dr. Karen Hauer is Associate Dean for Assessment and Professor of Medicine at the University of California, San Francisco (UCSF). She is an active researcher in medical education and a research mentor for fellows, residents and students, with a focus on new models of clinical learning in the workplace, competency-based medical education, learner assessment, coaching and remediation. In 2015, she completed a PhD in Medical Education through a joint program with UCSF and the University of Utrecht in the Netherlands. She directs the UCSF medical student coaching program. She is a practicing general internist, wife and mother of three!
    • Dr. Vanessa Thompson (@vthompsonmd) is a general internist and primary care provider at Zuckerberg San Francisco General Hospital. She also serves as the Academic Development Director for the Internal Medicine Residency Program and as a medical student coach at the University of California, San Francisco (UCSF).
  • A summary of insights from the ALiEM community derived from the Twitter and blog discussions
  • Freely downloadable PDF versions of the case and expert responses for use in continuing medical education activities
Expert Response 1: When Altruism Clashes With Reality (Dr. Nancy Dudek and Dr. Jessica Trier)
Expert Response 2: Failure to fail: Changing culture to support learners, faculty, and patients (Dr. Karen Hauer and Dr. Vanessa Thompson)
Curated from the Community (Dr. Eve Purdy)

Case and Responses for Download

Click here (or on the picture below) to download the case and responses as a PDF (321 kb).

Tamara McColl, MD FRCPC

Tamara McColl, MD FRCPC

Associate Editor, ALiEM MEdIC Series
Emergency Physician, St. Boniface Hospital, WRHA
Academic Lead, Educational Scholarship
Department of Emergency Medicine
University of Manitoba