The learning environment in remediation: a review

Abstract

Medical students are becoming increasingly diverse and medical curricula must create learning environments that support all students to thrive. Effective remediation should not be about intensive 'teaching to test' after examination failure. Rather, both the context and the individual have a role to play in ensuring the selection, teaching, assessment and feedback practices support the learning journeys of individuals. We provide guidance for faculty member development and engaging with students to help achieve this goal. Effective remediation should not be about intensive 'teaching to test' after examination failure.

Rethinking Education Environment: The Clinical Education Environment Framework

“…The Clinical Education Environment Framework (Figure 1) instruments used to measure educational environment such as in DREEM and LEQ (19,31), it appears as a major theme in this study. We argue that assessment is an essential component associated with educational environment as it is a powerful drive in students learning (33,55). Therefore, on top of teaching and learning elements, assessment should be considered into account when thinking about clinical education environment.…”

A holistic remediation intervention for struggling undergraduate medical students affords sustained Progress Test performance recovery

“…Factors associated with chronic medical student underperformance are often multiple, complex and interlinked, with more targeted holistic remediation interventions have been advocated (Cleland, Cilliers and van Schalkwyk, 2018). The remediation intervention described in the present study is a holistic approach to support chronically struggling students.…”

Physician remediation: accepting and working with complementary conceptualisations

“…That is, it might be more pragmatic to consider these two conceptualisations as complementary, with most remediation cases considered as a blend of the two. Although the shift towards competency‐based medical education strongly supports the idea that remediation is increasingly about providing appropriate support, the path to remediation inevitably involves some kind of repeated failure to fulfil the social and professional contract of the physician that could impact patient safety, which appropriately invokes a regulatory component. Therefore, it is not only practical, but indeed necessary to hold both conceptions simultaneously.…”

“…Stigmatisation, loss of autonomy and the resulting sense of ‘de‐professionalisation’ are well‐founded concerns raised in relation to physician remediation . A systemic approach to remediation has been recommended as one way of addressing the challenges that are part of implementing physician remediation . This requires the full involvement of stakeholders at all levels, from the remediating student and his or her teachers to the various levels of the institution and the society within which it is situated, so that the idea of remediation becomes normalised and accepted at all levels.…”

“…2,3 A systemic approach to remediation has been recommended as one way of addressing the challenges that are part of implementing physician 1 remediation. 4,7,8 This requires the full involvement of stakeholders at all levels, from the remediating student and his or her teachers to the various levels of the institution and the society within which it is situated, 4,7 so that the idea of remediation becomes normalised and accepted at all levels. Still, even within a well-designed systemic approach, there will be a need for both supportive and regulatory components of remediation.…”