Guidelines for Addressing Unsatisfactory Performance or Problematic Behaviors in CAPS Post-MSW Fellowship

A. Verbal Warning

Direct communication and verbal warning to the fellow identifying the unsatisfactory behavior and/or the need to discontinue the problematic behavior.

Examples: A meeting is scheduled with the fellow, their supervisors, training committee, and/or Assistant Coordinator of Training, to discuss the fellow’s failure to submit progress notes in a timely manner, or the fellow’s tardiness to meetings or work.

B. Initial Written Acknowledgement

Written acknowledgement to the fellow formally stating:

1. That the Assistant Coordinator of Training, training committee and supervisors are aware of and concerned about

    unsatisfactory progress and/or problematic behavior;

2. That the concerns have been brought to the fellow;

3. That the Assistant Coordinator of Training, training committee, and/or supervisors will work with the fellow to rectify the skill deficit and/or problem behavior and;

4. That the skill deficit and/or problem behaviors are not significant enough to warrant more

    serious action at that time, but that if the deficit and/or behavior continues, or if additional

    performance or behavioral issues arise, additional action may be warranted, up to and

    including dismissal from the fellowship program.

An example: Three months into the training year, a fellow demonstrates an ongoing skill deficit in determining appropriate level of care during triage. A plan is agreed upon that requires additional reading and focus in supervision so that the fellow can “catch up” to a level of competency consistent with her/his level of training.

C. Written Warning

Written warning to the fellow indicates the ongoing need to address unsatisfactory progress and/or discontinue problematic behavior. The written warning will contain:

1. A description of the fellow’s unsatisfactory progress and/or problematic behavior;

2. Specific actions required by the fellow to address unsatisfactory progress and/or correct

    problematic behavior;

3. The time line for addressing the area of concern; and

4. What action will be taken if the unsatisfactory progress and/or problematic behavior is not

    corrected.

An example: An fellow consistently violates a specific CAPS policy or procedure or does not adequately address areas of unsatisfactory progress and/or problematic behavior specified in Procedure B above.

D. Schedule Modification

Schedule modification is a time-limited, remediation-oriented, closely supervised period of training used to assist the fellow in overcoming unsatisfactory progress and/or problematic behavior, often associated with personal reactions to environmental stress, with the full expectation that the fellow will complete the fellowship. Any element of the training program is subject to schedule modification. Schedule modification may include, but is not limited to:

1. Increasing the amount of supervision, either with the same or other supervisors;

2. Changing the format, emphasis and/or focus of supervision;

3.  Recommending personal and/or professional development, as deemed appropriate;

4. Reducing or otherwise modifying the fellow's clinical or other workload;

5. Requiring specific didactic activities.

The Assistant Coordinator of Training, in consultation with the Coordinator of Training, training committee, and/or individual supervisor(s) will determine the length of the schedule modification period. Generally, the documentation will include the reasons for the schedule modification, the actions taken, and the basis for a decision to return to a normal schedule.

E. Probation

Probation is also a time limited, remediation-oriented, closely supervised training period. Typically, probation is a response to unsatisfactory progress and/or problematic behavior that requires the training staff to assess the ability of the fellow to successfully complete the fellowship. The purpose of probation is to clearly identify and define the problem area and to specify what needs to be done to improve the fellow’s performance or behavior. During probation, the Assistant Coordinator of Training, in consultation with appropriate supervisor(s), systematically monitors for a specific length of time the degree to which the fellow addresses, changes, or otherwise improves the unsatisfactory progress and/or problematic behavior. Generally, the fellow is informed in a written statement that includes;

1. The specific skill deficits and/or problematic behaviors that need remediating;

2. The recommendation for rectifying the problem, including any recommendations for personal

    and/or professional development, as deemed appropriate;

3. The time frame for the probation during which the problem is expected to be ameliorated;

4. The procedure to ascertain whether the problem has been appropriately rectified; and

5. The consequences of not ameliorating the identified performance or behavior issues.

Examples: Supervisor evaluations in one or more of the major competency areas reflect significant skill deficits inconsistent with level of training and/or expected level of development, supervisor(s’) reports indicate consistent significant lapses in ethical or professional judgment, or client care is jeopardized based on the decisions and/or behaviors of the trainee.

F. Notice of Insufficient Improvement

If the Assistant Coordinator of Training determines, in consultation with the appropriate supervisor(s), that there has not been sufficient improvement in the fellow’s progress and/or behavior to remove either the schedule modification or probation, the Assistant Coordinator of Training and the training committee will discuss possible courses of action to be taken. The Assistant Coordinator of Training will communicate in writing to the fellow that the conditions for revoking the probation or modified schedule have not been met. This notice will include the course of action the Coordinator of Training has decided to implement. These may include, but are not limited to:

1. Continuation of the remediation efforts for a specified time period;

2. Suspension of direct service activities for a specified time period;

3. Paid administrative leave, which involves the temporary withdrawal of all responsibilities; or

4. Dismissal from the fellowship, which involves the termination of all CAPS fellowship program

    responsibilities and privileges.

G. Dismissal

Generally, the above guidelines are intended to aid the fellow achieving expected competencies for their level of development and their training goals. However, staff may feel that in spite of adequate feedback and remediation, the fellow is still unable to make sufficient gains in areas addressed, or that immediate dismissal from the program is warranted without implementing any of the remediation efforts identified above. The Coordinator of Training, training committee, and/or the appropriate supervisor(s) will meet to determine the fellow’s progress. One outcome may be that the fellow is dismissed from the fellowship, which involves the termination of all CAPS fellowship program responsibilities and privileges. Fellows who are dismissed prior to their completion of the program as a result of unsatisfactory progress and/or other problematic behaviors will receive a written dismissal notice, which will include the actions resulting in the dismissal and, if applicable, any previous attempts to address the concerns.

*Note: In A through G, Assistant Coordinator of Training and training committee will consult with Coordinator of Training, and Coordinator of Training may stand in for Assistant Coordinator of Training if indicated or needed.

H. Fellow response to training program concerns.  A fellow may respond in writing to a written warning, schedule modification, probation, notice of insufficient improvement or dismissal.  In addition, a fellow may use the Formal Grievance (Review Committee) process in Part B of the Grievance Procedures for Post-MSW Fellows (below) to formally challenge a written warning, schedule modification, probation, notice of insufficient improvement or dismissal.  A fellow who wishes to use the Formal Grievance (Review Committee) process to challenge a written warning, schedule modification, probation, notice of insufficient improvement or dismissal must submit the written statement required to initiate that process within 5 working days of the fellow’s receipt of written notice of the decision being challenged.

Move on to Grievance Procedures of Post-MSW Fellows