The faculty experience with the "troublesome" family practice resident.
BACKGROUND
Some family practice residents, by virtue of their behavior, generate discomfort, anger, and ambivalence in their supervising colleagues. These residents are labeled "troublesome." The purpose of this qualitative research was to identify and conceptualize characteristics of troublesome residents.


METHODS
We retrospectively reviewed written evaluations of four residents who, out of a total of 111 residents in our program over five years, had been labeled "troublesome." Using the approach of constant comparisons, we identified a conceptual framework that described the troublesome residents.


RESULTS
We were able to classify the comments in the residents' written evaluations into three categories. The first category was troublesome residents' discomforting behaviors. These included affronting, avoiding responsibility, and lack of initiative. The second category included ways in which the resident failed to meet faculty and program expectations, often manifest as lack of collaboration and commitment. The third category of comments involved the process of recognizing and dealing with the troublesome resident. This occurred in a three-stage process involving recognition, confrontation, and remediation.


CONCLUSIONS
The classification of troublesome residents' performances into conceptual categories may be useful for helping faculty understand and deal with these learners.
Grams
G D
GD
Department of Family Practice, Faculty of Medicine, University of British Columbia.
Longhurst
M F
MF
Whiteside
C B
CB
D001519:Behavior; D001955:British Columbia; D005180:Faculty, Medical; D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D012189:Retrospective Studies