Few studies exist related to struggling learners in medical education; however, remediation programs, like the one Jeannette Guerrasio, MD and her team facilitate at the University of Colorado School of Medicine (SOM), are proving to be successful.
Dr. Guerrasio is Associate Professor in the Department of Medicine. She and her team recently published findings related to deficit types and predictors of poor academic outcomes in learners referred to the university’s remediation program. While remediation required substantial resources, the team concluded remediation was successful for 90 percent of learners. Not only did the remediation work, learners also reported that the program helped them as individuals.
The remediation program at the SOM helps learners referred (or self-referred) to the program by diagnosing areas of deficiency and creating strategies for remediation based on the individual student. With the Offices of Student Life and Graduate Medical Education, struggling learners are matched with the proper resources, like the Center for Advancing Professional Excellence (CAPE), communication coaches, mental health services, and more. Dr. Guerrasio and her team ensure remediation is timely and appropriate.
This study looked at outcomes for 151 learners who were referred to the program from 2006-2012. Learners were assessed and given individualized learning plans that incorporated deliberate practice, feedback and reflection. Data was collected related to training levels, the identified deficits, remediation plan details, outcomes and the time investment of faculty. The study concluded with an independent reassessment of learner achievement of goals.
- Most learners had more than one deficit.
- The most common deficits were related to medical knowledge, clinical reasoning and professionalism.
- Medical students (as opposed to residents and fellows) were more likely to have mental well-being issues
- Men struggled with communication and mental well-being more than women.
- Poor professionalism was the only predictor of probationary status. Faculty on the remediation team spent significantly more time with learners requiring remediation of clinical reasoning and mental well-being. Per hour, faculty face time reduced the odds of probation by 3.1 percent and all negative outcomes by 2.6 percent.
Dr. Guerrasio cautions there were limitations to this study and points out that future studies need to look at comparing strategies for effective remediation and optimizing faculty time.
“We respect the fact that not every student is going to succeed. This program focuses on maximizing the successes of those who are able to stay in medicine,” said Dr. Guerrasio. “We help those learners who discover that medicine might not be the best fit to find better uses for their skill sets.”