Twelve tips for developing and maintaining a remediation program in medical education

Abstract

Remediation in medical education, the process of facilitating corrections for physician trainees who are not on course to competence, predictably consumes significant institutional resources. Although remediation is a logical consequence of mandating, measuring, and reporting clinical competence, many program leaders continue to take an unstructured approach toward organizing effective, efficient plans for struggling trainees, almost all of who will become practicing physicians. The following 12 tips derive from a decade of remediation experience at each of the authors’ three institutions. It is informed by the input of a group of 34 interdisciplinary North American experts assembled to contribute two books on the subject. We intend this summary to guide program leaders to build better remediation systems and emphasize that developing such systems is an important step toward enabling the transition from time-based to competency-based medical education.

Disclosure statement

All three authors receive royalties from the publication of books on the subject of remediation in medical education.

Notes on contributors

Adina Kalet, M.D., M.P.H., is the Gold Professor of Humanism and Professionalism at New York University School of Medicine where she directs the Research on Medical Education Outcomes unit within the Division of General Internal Medicine and Clinical Innovation (DGIMCI). She is a founding Fellow of the American Academy on Communication in Healthcare and has received a number of teaching awards as well as the SGIM National Award for Scholarship in Medical Education in 2008. Along with many colleagues, and as a primary care physician and medical education researcher, she has worked with students, residents, and colleagues who needed extra support to become the best healthcare professionals possible.

Jeannette Guerrasio, MD, is an Associate Professor of Medicine at the University of Colorado School of Medicine, where she is the director of the medical student and graduate medical education remediation programs. She has provided remedial teaching to over 500 students, residents, and fellows and is the author of a book on remedial teaching entitled Remediation of the Struggling Medical Learner. She has also received the SGIM National Award for Scholarship in Medical Education in 2014.

Calvin L. Chou, M.D., Ph.D., is Professor of Clinical Medicine and Academy Chair in the Scholarship of Teaching and Learning at UCSF, and staff physician at the VA Medical Center in San Francisco. As a faculty member of the American Academy on Communication in Healthcare, he is nationally recognized for his efforts in education and research to enhance communication between patients and physicians. He is a founding member of the Clinical Skills Guidance Program at UCSF, has published seminal work on clinical skills remediation topics, and is co-editor, with Adina Kalet, of the book Remediation in Medical Education: A Midcourse Correction.