176 The incidence and effectiveness of remedial programs of the Medical Radiation Sciences Program at University of Toronto and the Michener Institute for Applied Health Sciences

Szumacher, Ewa; Catton, Pamela; Jones, Gareth H.; Bradley, R.; Kwan, Julie; Nyhof-Young, Joyce; Parker, Camilla

doi:10.1016/s0167-8140(05)80337-8

Cited by 14 publications

(39 citation statements)

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“…There is abundant literature on the pedagogical principles governing remediation in the clinical context (Gallant, MacDonald, & Smith Higuchi, 2006;Hauer et al, 2007;Johnson, 2004;Perin, 2001;Steinert & Lewitt, 1993;Szumacher et al, 2007). These studies suggest that effective remediation entails identifying difficulties early in the training curriculum, informing the students and instituting appropriate remediation measures.…”

Section: Remediation Of Clinical Reasoning Difficulties General Findimentioning

confidence: 99%

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Clinical Reasoning: Where Do We Stand on Identifying and Remediating Difficulties?

Audétat¹,

Lubarsky²,

Blais³

et al. 2013

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Ten to fifteen percent of medical trainees have academic difficulties, the majority of which are cognitive in nature, including clinical reasoning. Many obstacles impede the rapid identification of clinical reasoning difficulties in medical learners. This article reviews the literature on detection and remediation of clinical reasoning difficulties, and offers specific, practical steps for accurately diagnosing and quickly resolving identified problems with clinical reasoning. Faculties need to become more involved in the development and establishment of tools for encouraging direct observation of the development of clinical reasoning in medical learners, and for strengthening the teachers' pedagogical competencies.

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Section: Remediation Of Clinical Reasoning Difficulties General Findimentioning

confidence: 99%

“…Several authors also emphasize the difficulty of determining which strategy is best suited to a given problem. They cite the multifactorial nature of difficulties added to teacher uncertainty with respect to the methods used in trying to explain it Saxena et al, 2009;Szumacher et al, 2007).…”

Section: Specific Remediations For Clinical Reasoning Difficultiesmentioning

confidence: 99%

Clinical Reasoning: Where Do We Stand on Identifying and Remediating Difficulties?

Audétat¹,

Lubarsky²,

Blais³

et al. 2013

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“…[1][2][3][4][5] Most learners have difficulty with cognitive domains, including the application of medical knowledge in the form of clinical reasoning. [3][4][5][6][7][8][9] There is a lack of evidence to guide best practices in remediation and no widely accepted framework for the remediation of clinical reasoning. When focus groups were conducted with clinical educators, the participants stated they did not have a structured or systematic approach for remediation, and expressed skepticism about the impact of remediation on clinical reasoning.…”

Section: Introductionmentioning

confidence: 99%

Methods and Outcomes for the Remediation of Clinical Reasoning

Guerrasio

Aagaard

2014

J GEN INTERN MED

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INTRODUCTION:There is no widely accepted structured, evidence based strategy for the remediation of clinical reasoning skills. AIM: To assess the effectiveness of a standardized clinical reasoning remediation plan for medical learners at various stages of training. SETTING: Learners enrolled in the University of Colorado School of Medicine Remediation Program. PROGRAM DESCRIPTION: From 2006 to 2012, the learner remediation program received 151 referrals. Referrals were made by medical student clerkship directors, residency and fellowship program directors, and through self-referrals. Each learner's deficiencies were identified using a standardized assessment process; 53 were noted to have clinical reasoning deficits. The authors developed and implemented a ten-step clinical reasoning remediation plan for each of these individuals, whose subsequent performance was independently assessed by unbiased faculty and senior trainees. Participant demographics, faculty time invested, and learner outcomes were tracked. PROGRAM EVALUATION: Prevalence of clinical reasoning deficits did not differ by level of training of the remediating individual (p=0.49). Overall, the mean amount of faculty time required for remediation was 29.6 h (SD=29.3), with a median of 18 h (IQR 5-39) and a range of 2-100 h. Fiftyone of the 53 (96 %) passed the post remediation reassessment. Thirty-eight (72 %) learners either graduated from their original program or continue to practice in good standing. Four (8 %) additional residents who were placed on probation and five (9 %) who transferred to another program have since graduated. DISCUSSION: The ten-step remediation plan proved to be successful for the majority of learners struggling with clinical reasoning based on reassessment and limited subsequent educational outcomes. Next steps include implementing the program at other institutions to assess generalizability and tracking long-term outcomes on clinical care.

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“…Around 10–15% of medical students experience academic difficulties 5–12 . The majority of difficulties are of a cognitive nature and include difficulties in clinical reasoning 7,10–12 .…”

Section: Introductionmentioning

confidence: 99%

What is so difficult about managing clinical reasoning difficulties?

et al. 2012

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In order to improve the current state of affairs in the management of clinical reasoning difficulties, a collective paradigm shift is required to alter the perception of residency as an apprenticeship to one of residency as a structured educational programme. Faculty development programmes should be designed in an integrated way so that they not only develop clinical educators' skills, but also modify their beliefs.

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176 The incidence and effectiveness of remedial programs of the Medical Radiation Sciences Program at University of Toronto and the Michener Institute for Applied Health Sciences

Cited by 14 publications

References 0 publications

Clinical Reasoning: Where Do We Stand on Identifying and Remediating Difficulties?

Clinical Reasoning: Where Do We Stand on Identifying and Remediating Difficulties?

Methods and Outcomes for the Remediation of Clinical Reasoning

What is so difficult about managing clinical reasoning difficulties?

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