An Organized Approach to RESIDENT REMEDIATIONMARIA E. MOREIRA AND ERIC D. KATZ

Is the frog going to fall?

If I give you a stick, can you affect the outcome?

By the end of this session you will:

1. Define the resident who needs remediation

2. Recognize a four step approach to remediation

3. Apply these steps to a struggling resident

What is remediation?

The act or process of correcting a fault or deficiency

Questions:1. Which residents have faults or

deficiencies?

2. Do they ALL need remediation?

Do you know me?

Good In-Service Scores

Taking shortcuts for efficiency

Incomplete workups Confabulating when

not sure of answers Seems to just tell you

what you want to hear (Yes Man)

Does he need remediation?

Do you know me?

Exceptionally bright

Organized and responsible

Gets along well with everyone

Develops an intention tremor

Does she need remediation?

Last one

Hard working, bright, dedicated and professional

Very personable

He’s showing up late Wrinkled scrubs and not

shaving Off his game Still competent but

making mistakes

Does he need remediation?

Remediation is…

The act or process of correcting a fault or deficiency

It is done in as organized and objective fashion as possible

Four Essential Steps

a. Competence assessmentb.      Diagnosis of deficiency and development of individualized learning plansc.       Instruction/remediation with deliberate practice, feedback, and reflectiond.      Focused reassessment and certification of competence

Acad Med:84(12);1822-32

Competence Assessment

Requires reliable and valid assessment tools

ACGME toolbox of assessment methods

May need outside help

Deficiency Diagnosis + Individualized Learning Plan

Based on assessment tools used Based on deficiency needing

remediation Based on individual being

remediated Based on resources

Instruction/Remediation

Activities need to address deficiencies

Provide opportunity for deliberate practice, feedback, and reflection

Reassessment

Reassess for progress Continuously End of remediation period

Can use same modalities as for diagnosis

Can use more focused tools

Other Important Components

Set early clear expectations Educate faculty on assessment tools

Who will be involved in remediation Obtain resident buy-in and

involvement in development of plan Set clear timeline for reassessment

and contingency plans

Welcome to your Oral Boards! PROGRAM DIRECTOR EDITION

Today you will be taking the PD practical skills assessment

Two cases Group effort

Goals:1. Work through the steps of each

remediation2. Focus on the practicalities3. We will provide guidance and role

play the personnel

Have fun!

Conclusions

Remediation is an essential aspect of Resident Education

Essentials for Remediation include: Identification Good assessment tools Individualized plans Faculty and Resident buy in Clear goals

Questions?