Table 1
Criteria for strength of recommendation
|
Strong |
A large and consistent body of evidence |
|
Moderate |
Solid empirical evidence from one or more papers plus consensus of the authors |
|
Tentative |
Limited empirical evidence, but clear consensus of the authors |
Table 2
Summary of guidelines for remediation in medical education
|
Guideline |
Systems level, Do’s |
Recommendation |
|---|---|---|
|
1 |
Do advertise to the entire medical education community that learners commonly need remediation, which is resourced and available to all learners |
Tentative |
|
2 |
Do develop a robust feedback culture that impels learner improvement |
Moderate |
|
3 |
Do align selection and assessment systems with desired outcomes and graduate qualities |
Strong |
|
4 |
Do construct strategies aimed at averting the need for remediation |
Strong |
|
5 |
Do deliver remediation as highly individualized processes while recognizing common patterns across struggling learners |
Moderate |
|
6 |
Do ‘feed forward’ remediation information, with an abundance of caution |
Moderate |
|
7 |
Do provide faculty development and tangible support for frontline educators in early identification of, effective interventions for, and appropriate referral of struggling learners |
Tentative |
|
8 |
Do separate the individuals conducting the remediation process from those who determine the outcome of remediation |
Tentative |
|
9 |
Do ensure due process, balancing empathy for individual students’ struggles with the medical profession’s responsibility to society |
Moderate |
|
10 |
Do create compassionate alternative pathways for those who do not choose to or cannot complete medical training |
Tentative |
|
Remediation process, Do’s | ||
|
11 |
Do aim to detect a need for remediation early |
Moderate |
|
12 |
Do collect relevant data from multiple sources across case content |
Strong |
|
13 |
Do explore multiple causes of learner struggle beyond educational or workplace issues |
Strong |
|
14 |
Do intervene proactively with struggling learners—do not rely on their initiative |
Strong |
|
15 |
Do have trainees in remediation undergo intensive, longitudinal tutoring with emphasis on study skills, collaboratively designed plans, frequent high-quality feedback, and individualized assessment |
Strong |
|
16 |
Do assess for and improve skills in learning self-regulation |
Strong |
|
17 |
Do remediate knowledge and skills in small groups with expert facilitators |
Moderate |
|
18 |
Do follow up with learners, even after the presumed end of the remediation period |
Moderate |
|
Don’ts | ||
|
19 |
Don’t rely solely on traditional academic markers of performance |
Moderate |
|
20 |
Don’t merely give more time, repeat the learner experience, give general or vague advice, or just ‘teach to the test’ without additional support |
Strong |
|
Don’t knows | ||
|
21 |
What are the long-term outcomes of remediation? | |
|
22 |
What is the optimal blend and duration of remediation? | |
|
23 |
How does remediation fit with CBME and its approach of learner-centredness and de-emphasis of time? | |
|
24 |
What is the optimal balance between the benefits of educational handovers and the need to protect learners from negative bias that may arise from such handovers? | |
|
25 |
What specific measures predict the need for remediation? | |
|
26 |
Apart from establishing a longitudinal remediation program (Guideline 15), what are the most effective remediation practices? |