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A Research Agenda for Remediation in Medical Education

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Remediation in Medical Education

Abstract

The evidence base underlying remediation in medical education is limited but growing rapidly as better competency-based assessments allow us to identify increasing numbers of struggling learners. In this chapter the authors frame a research agenda for remediation in four major areas: diagnosis of learner deficits, strategies for remediation, outcomes of remediation, and faculty development. They briefly review the key issues within each area and identify questions that need to be addressed through further research. Finally, they frame a research agenda, call for a coordinated multi-institutional approach to address this pressing educational need, and identify emerging domains where research questions and opportunities are likely to arise.

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References

  1. Cleland J, Leggett H, Sandars J, Costa MJ, Patel R, Moffat M. The remediation challenge: theoretical and methodological insights from a systematic review. Med Educ. 2013;47:242–51.

    Article  PubMed  Google Scholar 

  2. Audetat M, Laurin S, Dory V. Remediation of struggling learners: putting an end to “more of the same”. Med Educ. 2013;47:224–31.

    Article  Google Scholar 

  3. Carney PA, et al. Educational epidemiology. JAMA. 2004;292:1044–50.

    Article  PubMed  CAS  Google Scholar 

  4. Dupras DM, Edson RS, Halvorsen AJ, Hopkins Jr RH, McDonald FS. “Problem residents”: prevalence problems, and remediation in the era of core competencies. Am J Med. 2012;125:421–5.

    Article  PubMed  Google Scholar 

  5. Brenner AM, Mathai S, Jain S, Mohl PC. Can we predict “problem residents”? Acad Med. 2010;85:1147–51. doi:10.1097/ACM.0b013e3181e1a85d.

    Article  PubMed  Google Scholar 

  6. Sanfey H, DaRosa DA, Hickson GB, et al. Pursuing professional accountability: an evidence-based approach to addressing residents with behavioral problems. Arch Surg. 2012;147:642–7.

    Article  PubMed  Google Scholar 

  7. Kalet AL, Gillespie CC, Schwartz MD, Holmboe ES, Ark TK, Jay M, Paik S, et al. New measures to establish the evidence base for medical education: identifying educationally sensitive patient outcomes. Acad Med. 2010;85:844–51. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20520038

    Google Scholar 

  8. Eva K, Regehr G. Self-assessment in the health professions: a reformulation and research agenda. Acad Med. 2005;80:S46–54.

    Article  PubMed  Google Scholar 

  9. Srinivasan M, Hauer KE, Der-Martirosian C, Wilkes M, Gesundheit N. Does feedback matter? Practice-based learning for medical students after a multi-institutional clinical performance examination. Med Educ. 2007;41:857–65.

    Article  PubMed  Google Scholar 

  10. Langendyk V. Not knowing that they do not know: self-assessment accuracy of third-year medical students. Med Educ. 2006;40:173–9.

    Article  PubMed  Google Scholar 

  11. Winston KA, van der Vleuten CPM, Scherpbier AJJA. At-risk medical students: implications of students’ voice for the theory and practice of remediation. Med Educ. 2010;44:1038–47.

    Article  PubMed  Google Scholar 

  12. Todres M, Tsimtsiou Z, Sidhu K, Stephenson A, Jones R. Medical students’ perceptions of the factors influencing their academic performance: an exploratory interview study with high-achieving and re-sitting medical students. Med Teach. 2012;34:e325–31.

    Article  PubMed  Google Scholar 

  13. Hauer KE, Ciccone A, Henzel TR, Katsufrakis P, Miller SH, Norcross WA, Papadakis MA, Irby DM. Remediation of the deficiencies of physicians across the continuum from medical school to practice: a thematic review of the literature. Acad Med. 2009;84:1822–32.

    Article  PubMed  Google Scholar 

  14. Eva KW, Rosenfeld J, Reiter HI, Norman GR. An admissions OSCE: the multiple mini-interview. Med Educ. 2004;38:314–26.

    Article  PubMed  Google Scholar 

  15. Eva KW, Reiter HI, Rosenfeld J, Trinh K, Wood TJ, Norman GR. Association between a medical school admission process using the multiple mini-interview and national licensing examination scores. JAMA. 2012;308:2233–40.

    Article  PubMed  CAS  Google Scholar 

  16. Dunleavy DM, Kroopnick MH, Dowd KW, Searcy CA, Zhao X. The predictive validity of the MCAT exam in relation to academic performance through medical school: a national cohort study of 2001–2004 matriculants. Acad Med. 2013;88:666–71.

    Article  PubMed  Google Scholar 

  17. Winston KA, van der Vleuten CPM, Scherpbier AJJA. The role of the teacher in remediating at-risk medical students. Med Teach. 2012;34(11):e732–42.

    Article  PubMed  Google Scholar 

  18. Chou CL, Chang A, Hauer KE. Remediation workshop for medical students in patient–doctor interaction skills. Med Educ. 2008;42:537.

    Article  PubMed  Google Scholar 

  19. Durning SJ, Cleary TJ, Sandars J, Hemmer P, Kokotailo P, Artino AR. Viewing “strugglers” through a different lens: how a self-regulated learning perspective can help medical educators with assessment and remediation. Acad Med. 2011;86:488–95.

    Article  PubMed  Google Scholar 

  20. Brydges R, Butler D. A reflective analysis of medical education research on self-regulation in learning and practice. Med Educ. 2012;46:71–9.

    Article  PubMed  Google Scholar 

  21. Winston KA, Van der Vleuten CPM, Scherpbier AJJA. An investigation into the design and effectiveness of a mandatory cognitive skills programme for at-risk medical students. Med Teach. 2010;32:236–43.

    Article  PubMed  Google Scholar 

  22. Ten Cate OTJ, Kusurkar RA, Williams GC. How self-determination theory can assist our understanding of teaching and learning processes in medical education. Med Teach. 2011;33:961–73.

    Article  PubMed  Google Scholar 

  23. Saxena V, O’Sullivan PS, Teherani A, Irby DM, Hauer KE. Remediation techniques for student performance problems after a comprehensive clinical skills assessment. Acad Med. 2009;84:669–76.

    Article  PubMed  Google Scholar 

  24. Papadakis MA, Paauw DS, Hafferty FW, Shapiro J, Byyny RL. The education community must develop best practices informed by evidence-based research to remediate lapses of professionalism. Acad Med. 2012;87:1694–8.

    Article  PubMed  Google Scholar 

  25. Buchanan AO, Stallworth J, Christy C, Garfunkel LC, Hanson JL. Professionalism in practice: strategies for assessment, remediation, and promotion. Pediatrics. 2012;129:407–9.

    Article  PubMed  Google Scholar 

  26. Swiggart WH, Dewey CM, Hickson GB, Finlayson AJR, Spickard Jr WA. A plan for identification, treatment, and remediation of disruptive behaviors in physicians. Front Health Sci Manage. 2009;25:3–11.

    Google Scholar 

  27. Williams RG, Klamen DL, White CB, Petrusa E, Fincher RE, Whitfield CF, Shatzer JH, et al. Tracking development of clinical reasoning ability across five medical schools using a progress test. Acad Med. 2011;86:1148–54. doi:10.1097/ACM.0b013e31822631b3.

    Article  PubMed  Google Scholar 

  28. Aronson L. Twelve tips for teaching reflection at all levels of medical education. Med Teach. 2011;33:200–5.

    Article  PubMed  Google Scholar 

  29. Chang A, Chou CL, Teherani A, Hauer KE. Senior medical students’ clinical skills learning goals after performance feedback. Med Educ. 2011;45:878–85.

    Article  PubMed  Google Scholar 

  30. Cooke M, Irby DM, O’Brien BC. Educating physicians: a call for reform of medical school and residency. San Francisco: Jossey-Bass; 2010.

    Google Scholar 

  31. Schuwirth LW, van der Vleuten CP. Programmatic assessment: from assessment of learning to assessment for learning. Med Teach. 2011;33:478–85.

    Article  PubMed  Google Scholar 

  32. Driessen E, van Tartwijk J, Vermunt JD, van der Vleuten C. Use of portfolios in early undergraduate medical training. Med Teach. 2003;25:14–9. Retrieved from http://informahealthcare.com/doi/pdf/10.1080/0142159021000061378

    Google Scholar 

  33. Chang A, Boscardin C, Chou CL, Loeser H, Hauer KE. Predicting failing performance on a standardized patient clinical performance examination: the importance of communication and professionalism skills deficits. Acad Med. 2009;84:S101–4.

    Article  PubMed  Google Scholar 

  34. Cleary L. “Forward feeding” about students’ progress: the case for longitudinal, progressive, and shared assessment of medical students. Acad Med. 2008;83:800. doi:10.1097/ACM.0b013e318181cfbc. PubMed PMID: 18728429.

    Article  PubMed  Google Scholar 

  35. Cox SM. “Forward feeding” about students’ progress: information on struggling medical students should not be shared among clerkship directors or with students’ current teachers. Acad Med. 2008;83:801. PubMed PMID: 18728430.

    Article  PubMed  Google Scholar 

  36. Hauer KE, O’Brien BC, Hansen LA, Hirsh D, Ma IH, Ogur B, Poncelet AN, Alexander EK, Teherani A. More is better: students describe successful and unsuccessful experiences with teachers differently in brief and longitudinal relationships. Acad Med. 2012;87:1389–96.

    Article  PubMed  Google Scholar 

  37. Sargeant J, Mann K, Sinclair D, van der Vleuten C, Metsemakers J. Challenges in multisource feedback: intended and unintended outcomes. Med Educ. 2007;41:583–91.

    Article  PubMed  Google Scholar 

  38. Chou CL, Masters DE, Chang A, Kruidering-Hall M, Hauer KE. Effect of longitudinal small group learning on delivery of clinical skills feedback. Med Educ., in press.

    Google Scholar 

  39. Zbieranowski I, Takahashi SG, Verma S, Spadafora SM. Remediation of residents in difficulty: a retrospective 10-year review of the experience of a postgraduate board of examiners. Acad Med. 2013;88:111–6.

    Article  PubMed  Google Scholar 

  40. Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39:1005–26.

    Article  PubMed  Google Scholar 

  41. Papadakis MA, Teherani A, Banach MA, Knettler TR, Rattner SL, Stern DT, Veloski JJ, Hodgson CS. Disciplinary action by medical boards and prior behavior in medical school. N Engl J Med. 2005;353:2673–82. PubMed PMID: 16371633.

    Article  PubMed  CAS  Google Scholar 

  42. Dudek NL, Marks MB, Regehr G. Failure to fail: the perspectives of clinical supervisors. Acad Med. 2005;80:S84–7.

    Article  PubMed  Google Scholar 

  43. Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med. 1998;73:403–7.

    Article  PubMed  CAS  Google Scholar 

  44. Fenwick T. Re-thinking the “thing”: sociomaterial approaches to understanding and researching learning in work. J Workplace Learn. 2010;22:104–16.

    Article  Google Scholar 

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Correspondence to Calvin L. Chou M.D., Ph.D. .

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Chou, C.L., Kalet, A., Hauer, K.E. (2014). A Research Agenda for Remediation in Medical Education. In: Kalet, A., Chou, C. (eds) Remediation in Medical Education. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9025-8_21

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  • DOI: https://doi.org/10.1007/978-1-4614-9025-8_21

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