TABLE V.

Strategies to Support Learner Performance in Various Domains

Performance Domain	Examples	Strategies to Support Improvement
Knowledge	• Incomplete or inaccurate patient presentations, diagnoses, plan, and documentation • Low scores on rotation evaluations	• Address any cognitive barriers • Review study strategies and offer best practices • Establish clear expectations
Skills	• Clinical reasoning deficiencies • Physical diagnosis, procedural skill, and surgical skill deficiencies	• Ensure objective assessment • Provide video feedback of performance for self-reflection • Provide videos of desired/preferred technique and behavior • Ensure knowledge deficits are not driving skills performance gaps, if so, focus first on bridging knowledge gaps • Provide opportunities for practice and repeat performance
Behavior	• Unprofessional or disruptive behavior • Difficulty with timeliness, both at work and with administrative deadlines • Strained professional relationships • Not receptive to feedback	• Recognize that there are multiple perspectives on behaviors and inquire as to the learners’ experience • Recognize if bias or stereotyping play a role in perception of behavior • Offer tools to support organization (technology and coaching) • Encourage self-reflection • Emphasize accountability for the impact of behaviors on others, regardless of the intention • Build sense of safety and belonging