Section 5: When Nothing Else Works…

Precepting students in a clinical environment creates a mutually beneficial experience for the doctor, the student, and the patient, and we hope this is achieved with minimal effort from both interns and preceptors. However, when additional support is needed, this toolkit serves as a resource. In some cases, despite every effort—from adapting teaching strategies and communication styles, to providing direct observation, reflecting on interaction dynamics, engaging in heartfelt conversations, and diligently tracking progress—the student continues to struggle. When a preceptor has tried all reasonable approaches and nothing seems to make a meaningful difference, it is natural to wonder what else can be done. This section outlines the next steps to consider when all typical strategies have been exhausted.

Understand your triggers

1. Don’t make it personal
2. Remain objective
3. Be constructive not destructive

Mental Health Toolkit for the Preceptor

“Do’s and Don’ts” template by Maria Armandi, OD and Tami April-Davis, Psy.D. (Drexel University)

• Offers guidance when providing clinical performance feedback to students whose reactions may stem from learning differences or emotional and mental health disorders
• Learn to identify student emotional response type as “Externalizing” or “Internalizing” and adjust your delivery accordingly 
• Describes various types of students: unmotivated, confused, referral, emotional, anxious, dismissive
• Includes script for specific type of students

For examples of elements of this table, click below on “Guidelines for Difficult Conversations”