Anne Kendall, PhD, RD, LDN

Susan Brown, MS, RD, LDN

Primary Prevention: prevent the problem

before it occurs

Orient the intern well

Set clear expectations and goals
Determine the interns expectations and goals
Reassess mid-rotation

Secondary Prevention: early detection

Pay attention to your hunches/clues
Dont wait
Give specific feedback early and monitor closely

Tertiary Prevention: manage the problem to

minimize impact
Seek help
Dont be a martyr
Do not pass an intern who has not performed
satisfactorily

SOAP Approach
Subjective: what do you and others think?
Objective: what are the specific behaviors
observed
Assessment: form a differential diagnosis of the
problem
Plan: what next?

Subjective
Chief complaint: what made you think there was
a problem?
Has the intern been labeled?
What do you/others think?
What does the intern think does s/he perceive a
problem?

Objective
Identify and list specific instances of the behavior
to document the issues
Need specific information to intervene effectively

Assessment

Cognitive knowledge base

Clinical skills less than expected
Affective issues
Values
Environmental
Medical

Plan
Gather more data?
Get help
Intervene

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Curry, KR. Multicultural competence in dietetics and nutrition.
J Am Diet Assoc. 100:1142-1143, 2000.
Harden RM and Crosby JR. An extended summary of
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Guide No. 20, Medical Teacher 22(4): 334-347. (
http:/www.amee.org)
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www.parentleadership.com/worksavvy.html retrieved
January 29, 2007