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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
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.
Audetat M, Laurin S, Dory V. Remediation of struggling learners: putting an end to “more of the same”. Med Educ. 2013;47:224–31.
Carney PA, et al. Educational epidemiology. JAMA. 2004;292:1044–50.
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.
Brenner AM, Mathai S, Jain S, Mohl PC. Can we predict “problem residents”? Acad Med. 2010;85:1147–51. doi:10.1097/ACM.0b013e3181e1a85d.
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.
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
Eva K, Regehr G. Self-assessment in the health professions: a reformulation and research agenda. Acad Med. 2005;80:S46–54.
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.
Langendyk V. Not knowing that they do not know: self-assessment accuracy of third-year medical students. Med Educ. 2006;40:173–9.
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.
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.
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.
Eva KW, Rosenfeld J, Reiter HI, Norman GR. An admissions OSCE: the multiple mini-interview. Med Educ. 2004;38:314–26.
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.
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.
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.
Chou CL, Chang A, Hauer KE. Remediation workshop for medical students in patient–doctor interaction skills. Med Educ. 2008;42:537.
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.
Brydges R, Butler D. A reflective analysis of medical education research on self-regulation in learning and practice. Med Educ. 2012;46:71–9.
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.
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.
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.
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.
Buchanan AO, Stallworth J, Christy C, Garfunkel LC, Hanson JL. Professionalism in practice: strategies for assessment, remediation, and promotion. Pediatrics. 2012;129:407–9.
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.
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.
Aronson L. Twelve tips for teaching reflection at all levels of medical education. Med Teach. 2011;33:200–5.
Chang A, Chou CL, Teherani A, Hauer KE. Senior medical students’ clinical skills learning goals after performance feedback. Med Educ. 2011;45:878–85.
Cooke M, Irby DM, O’Brien BC. Educating physicians: a call for reform of medical school and residency. San Francisco: Jossey-Bass; 2010.
Schuwirth LW, van der Vleuten CP. Programmatic assessment: from assessment of learning to assessment for learning. Med Teach. 2011;33:478–85.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
Dudek NL, Marks MB, Regehr G. Failure to fail: the perspectives of clinical supervisors. Acad Med. 2005;80:S84–7.
Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med. 1998;73:403–7.
Fenwick T. Re-thinking the “thing”: sociomaterial approaches to understanding and researching learning in work. J Workplace Learn. 2010;22:104–16.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media New York
About this chapter
Cite this chapter
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
Download citation
DOI: https://doi.org/10.1007/978-1-4614-9025-8_21
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-9024-1
Online ISBN: 978-1-4614-9025-8
eBook Packages: MedicineMedicine (R0)