Untying the Gordian knot: remediation problems in medical schools that need remediation

Abstract

This position paper discusses on-going academic remediation challenges within the field of medical education. More specifically, we identify three common contemporary problems and propose four recommendations to strengthen remediation efforts. Selecting or determining what type of remediation is needed for a particular student is akin to analyzing a Gordian knot with individual, institutional and systemic contributors. More emphasis, including multi-institutional projects and research funding is needed. Recommendations regarding language use and marketing of such programs are given.

Guidelines: The dos, don’ts and don’t knows of remediation in medical education

“…In this model, many, if not most, students might need support at one time or another [27]. Indeed, we advocate explicitly reframing, and thereby destigmatizing, remediation as a special zone of learning, self-improvement, personal development, resilience building, and an opportunity to practise with feedback, all to develop the adaptive capacity needed by all medical professionals in the current era [27, 40, 41]. This goal requires that program leadership and faculty embody this approach in substantial ways.…”

Physician remediation: accepting and working with complementary conceptualisations

“…Affected stakeholders such as regulators, patients, care providers and the public are increasingly paying attention to medical underperformance . Even with such attention to physician performance and accountability, the remediation of practising physicians continues to be plagued by various challenges . Opining that challenges with physician remediation are in part due to our limited understanding of how remediation of practising physicians is conceptualised, Bourgeois‐Law et al conducted a qualitative study exploring the conceptualisation of the remediation of practising physicians.…”

“…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 .…”

“…1 Even with such attention to physician performance and accountability, the remediation of practising physicians continues to be plagued by various challenges. 2 Opining that challenges with physician remediation are in part due to our limited understanding of how remediation of practising physicians is conceptualised, Bourgeois-Law et al 3 conducted a qualitative study exploring the conceptualisation of the remediation of practising physicians. In an article featured in this issue, the authors identify two conceptualisations of remediating practising physicians: remediation as an educational process on a continuum of learning and remediation as a regulatory process.…”

“…Stigmatisation, loss of autonomy and the resulting sense of 'de-professionalisation' are well-founded concerns raised in relation to physician remediation Stigmatisation, loss of autonomy and the resulting sense of 'de-professionalisation' are wellfounded concerns raised in relation to physician remediation. 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.…”