Remediation of the deficiencies of physicians across the continuum from medical school to practice: a thematic review of the literature

Academic Medicine : Journal of the Association of American Medical Colleges
Karen E HauerDavid M Irby

Abstract

Despite widespread endorsement of competency-based assessment of medical trainees and practicing physicians, methods for identifying those who are not competent and strategies for remediation of their deficits are not standardized. This literature review describes the published studies of deficit remediation at the undergraduate, graduate, and continuing medical education levels. Thirteen studies primarily describe small, single-institution efforts to remediate deficient knowledge or clinical skills of trainees or below-standard-practice performance of practicing physicians. Working from these studies and research from the learning sciences, the authors propose a model that includes multiple assessment tools for identifying deficiencies, individualized instruction, deliberate practice followed by feedback and reflection, and reassessment. The findings of the study reveal a paucity of evidence to guide best practices of remediation in medical education at all levels. There is an urgent need for multiinstitutional, outcomes-based research on strategies for remediation of less than fully competent trainees and physicians with the use of long-term follow-up to determine the impact on future performance.

References

Sep 1, 1992·Academic Medicine : Journal of the Association of American Medical Colleges·G R Norman, H G Schmidt
Apr 1, 1992·Academic Medicine : Journal of the Association of American Medical Colleges·G J Magarian, S M Campbell
Sep 1, 1991·Academic Medicine : Journal of the Association of American Medical Colleges·G Bordage, M Lemieux
Oct 1, 1990·Academic Medicine : Journal of the Association of American Medical Colleges·H G SchmidtH P Boshuizen
Jun 1, 1990·Academic Medicine : Journal of the Association of American Medical Colleges·E J Stemmler
Sep 1, 1990·Academic Medicine : Journal of the Association of American Medical Colleges·G E Miller
Nov 1, 1989·Academic Medicine : Journal of the Association of American Medical Colleges·D M Irby, S Milam
Nov 1, 1994·Academic Medicine : Journal of the Association of American Medical Colleges·G Bordage
Mar 1, 1993·Investigative Radiology·B S Edeiken
Feb 4, 1998·BMJ : British Medical Journal·S R Cruess, R L Cruess
Sep 16, 1998·Academic Medicine : Journal of the Association of American Medical Colleges·P L Schwartz, E G Loten
Dec 21, 2000·Medical Education·J Bligh
Feb 6, 2002·Annals of Internal Medicine·UNKNOWN ABIM Foundation. American Board of Internal MedicineUNKNOWN European Federation of Internal Medicine
Jul 12, 2002·Medical Education·Melissa SayerDiana Wood
Feb 27, 2004·Academic Medicine : Journal of the Association of American Medical Colleges·Lisa D Howley, William G Wilson
Apr 23, 2004·The New England Journal of Medicine·Maxine A Papadakis
Sep 24, 2004·Academic Medicine : Journal of the Association of American Medical Colleges·K Anders Ericsson
Mar 15, 2005·Medical Teacher·Pascal P McKeown, Mairead Boohan
Apr 9, 2005·Medical Education·Geoffrey Norman
May 27, 2005·Academic Medicine : Journal of the Association of American Medical Colleges·François GouletRobert Gagnon
Aug 30, 2005·Current Surgery·Nancy L HarthunHilary Sanfey
Oct 4, 2005·Academic Medicine : Journal of the Association of American Medical Colleges·Karen E HauerDavid M Irby
Dec 24, 2005·The New England Journal of Medicine·Maxine A PapadakisCarol S Hodgson
Jan 19, 2006·Annals of Internal Medicine·Lucian L Leape, John A Fromson
Jun 7, 2006·Medical Teacher·Richard L Cruess, Sylvia R Cruess
Sep 21, 2006·The Journal of Continuing Education in the Health Professions·Elizabeth F WenghoferDaniel J Klass
Oct 27, 2006·The New England Journal of Medicine·Frederic W Hafferty
Oct 27, 2006·The New England Journal of Medicine·David T Stern, Maxine Papadakis
Jan 26, 2007·The New England Journal of Medicine·Ronald M Epstein
Mar 28, 2007·The Journal of Continuing Education in the Health Professions·François GouletMarie-Eve Gingras
Aug 19, 2007·Medical Education·Marita LynaghRob Sanson-Fisher
Oct 18, 2007·Academic Medicine : Journal of the Association of American Medical Colleges·Karen E HauerDavid M Irby
Apr 17, 2008·Medical Education·Calvin L ChouKaren E Hauer
Aug 1, 2008·Academic Medicine : Journal of the Association of American Medical Colleges·Donna T ChenPatricia H Werhane
Aug 1, 2008·Academic Medicine : Journal of the Association of American Medical Colleges·Carol L CarraccioPamela L Derstine
Nov 11, 2008·Medical Education·Anna ChangKaren E Hauer
Feb 26, 2009·Academic Medicine : Journal of the Association of American Medical Colleges·Stephen J LurieJeffrey M Lyness
Jul 30, 2009·Academic Medicine : Journal of the Association of American Medical Colleges·William A NorcrossRichard E Hawkins
Aug 26, 2009·Academic Medicine : Journal of the Association of American Medical Colleges·Casey B WhiteLarry D Gruppen
Aug 26, 2009·Academic Medicine : Journal of the Association of American Medical Colleges·Karen E HauerPatricia S O'Sullivan

❮ Previous
Next ❯

Citations

Oct 15, 2010·Academic Medicine : Journal of the Association of American Medical Colleges·Jennifer R KoganEric S Holmboe
Oct 28, 2010·Academic Medicine : Journal of the Association of American Medical Colleges·Paul A HemmerKlara Papp
Oct 14, 2011·Academic Medicine : Journal of the Association of American Medical Colleges·Anthony R ArtinoSteven J Durning
Oct 26, 2012·Academic Medicine : Journal of the Association of American Medical Colleges·Maxine A PapadakisUNKNOWN Alpha Omega Alpha Honor Medical Society Think Tank
Nov 21, 2012·Academic Medicine : Journal of the Association of American Medical Colleges·Ingrid ZbieranowskiSalvatore M Spadafora
Apr 12, 2013·BMJ Quality & Safety·Thomas H Gallagher, Wendy Levinson
Apr 20, 2013·BMC Medical Education·Kevin McLaughlinBruce Wright
Jul 1, 2011·International Journal of Emergency Medicine·Sarah E Ronan-BentleDavid E Manthey
Jun 1, 2010·Journal of Graduate Medical Education·Jim S WuPhillip M Boiselle
Jan 24, 2014·Journal of Graduate Medical Education·Matthew AlexanderMary Nolan Hall
Mar 26, 2014·Academic Psychiatry : the Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry·Lara HazeltonKathryn Lightfoot
Oct 26, 2011·Medical Teacher·John Sandars, Timothy J Cleary
Feb 26, 2016·Journal of Graduate Medical Education·Linda ReganChristine Sullivan
Dec 15, 2012·The Journal of Emergency Medicine·Eric D KatzEthan D Fried
Nov 7, 2012·Journal of the American College of Surgeons·Hilary SanfeyGary Dunnington
Oct 21, 2010·American Journal of Clinical Pathology·Edward C KlattBrian R Smith
Aug 31, 2010·Gastroenterology·Arthur J DecrossDeborah D Proctor
Jun 14, 2012·Medical Education·Karen M Stegers-JagerAxel P N Themmen
Apr 21, 2012·Medical Education·Bernard CharlinChristian Bourdy
Jan 14, 2012·Medical Education·Marie-Claude AudétatBernard Charlin
Nov 9, 2010·Journal of the American Geriatrics Society·Jorge G RuizBernard A Roos
Feb 13, 2013·Medical Education·Marie-Claude AudétatValerie Dory
Feb 13, 2013·Medical Education·Jennifer ClelandMandy Moffat
Jan 15, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Eric D KatzUNKNOWN CORD-EM Remediation Task Force
Nov 23, 2011·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christine SullivanEric D Katz
Dec 16, 2010·Medical Education·Eric HolmboeElizabeth Bernabeo
May 7, 2010·Medical Education·Kevin W Eva
Jul 22, 2014·The Clinical Teacher·Brenda Stutsky
Mar 27, 2012·The American Journal of Medicine·Denise M DuprasFurman S McDonald
Mar 30, 2016·Advances in Health Sciences Education : Theory and Practice·Lotte Dyhrberg O'NeillBerit Eika
Sep 28, 2010·The Journal of Continuing Education in the Health Professions·François GouletAbdo Shabah
Jul 17, 2015·Anatomical Sciences Education·Audra F Schutte
Jul 16, 2015·Journal of General Internal Medicine·S Beth BiererJohn E Tetzlaff
Dec 12, 2012·Medical Teacher·Marie-Claude AudétatBernard Charlin
Jun 15, 2014·Advances in Health Sciences Education : Theory and Practice·Walther N K A van MookCees P M van der Vleuten
Jun 16, 2016·Surgery·Dimitrios StefanidisDanelle Higgins
Aug 2, 2016·Journal of Surgical Education·Becca L GasDavid R Farley
Sep 16, 2016·Medical Education·Roghayeh GandomkarJohn Sandars

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Journal of General Internal Medicine
D C Yao, S M Wright
Academic Medicine : Journal of the Association of American Medical Colleges
Varun SaxenaKaren E Hauer
The New England Journal of Medicine
Kapil Parakh
© 2022 Meta ULC. All rights reserved