Diagnosing the learner in difficulty.

A learner in difficulty is a student at risk for receiving less than “pass” because of concerns regarding his or her knowledge base, clinical skills, or professionalism.1 Learners in difficulty rarely self-identify for a variety of reasons, including lack of self-awareness or concern that if they acknowledge they are in difficulty, they will be stigmatized.2 However, early identification of such individuals, with appropriate intervention, seems to lead to better outcomes for these learners.3 The responsibility of identifying learners who are not meeting expectations largely rests with their clinical teachers.