1. Trends Among Medical Students and Physicians
Referred for Remediation
Jeannette Guerrasio & Eva Aagaard
University of Colorado Anschutz Medical Campus
BACKGROUND RESULTS
p=0.061
 7-28% of medical students and residents Mental Well Being p=0.025
Mental Well Being
struggle during training Systems Based Practice
Systems Based Practice
 17% of attendings can identify peers in need of Problem Based Learning and
Problem Based Learning and Improvement Improvement
remediation
p=0.009
 Few small studies on remediation in the Communication
Communication
literature Interpersonal Skills Interpersonal Skills
Professionalism Professionalism
PURPOSE Time Management and Organization Time Management and Organization
 To determine trends among medical trainees Clinical Reasoning Post Residency Clinical Reasoning
and physicians referred for remediation Clinical Skills
Residents
Clinical Skills Female
 To identify predictors of poor academic or Medical Students
Medical Knowledge Medical Knowledge Male
career outcomes among struggling medical
students, residents and attending physicians 0 10 20 30 40 50 60 0 10 20 30 40 50
Figure 1: Percentage of Learners with Deficit Figure 2: Percentage of Learners with Deficit
Based on Level of Training. While trends emerge, the Based on Gender. Mental well-being and
METHODS only statistically significant finding is that mental well-being communication difficulties are more common in males.
Recruitment difficulties are more common in medical students.
From 2006-2012, the remediation program at 80 Additional Findings:
the University of Colorado School of Medicine 70 •Among students, difficulty with interpersonal skills
(n=151) 60 trended towards not matching into a residency
Referrals include: 50 program (p=0.087).
Self-referrals 40 •Poor professional was the only predictor of
Medical student clerkship directors 30 probationary status (p=0.001).
Residency and fellowship program 20 •Probation status was predictive of negative
director 10 outcome, including restricted practice, being
Students who received negative 0
transferred to another program, withdrawal and
comments on their evaluations dismissal (p<0.0001).
All learners in and danger of failing •Faculty time reduced the odds of probation by
Learners who have failed a course or 3.1% per hour and reduced negative outcomes by
Figure 3: Direct Faculty Mentoring Time in Hours
rotation 2.6% per hour (p=0.001, OR 0.969;p=0.002, OR
Required for Remediation Based on Deficit. Clinical
reasoning, and mental well being struggles each required 0.974)
Data Collected significantly most faculty time to remediate (p<0.001;p=0.03)
Gender
Level of learner
Deficiency KEY LESSONS
Assessment Method Deficits among learners referred for remediation vary based on the level of learner.
Additional Faculty Time Needed The type of deficit can be used to predict the amount of time needed for remediation,
Outcomes not matching into a residency program, probationary status and negative academic and
career outcomes.
Analysis Methods
Faculty time dedicated to remediation has been shown to decrease probation and
•Chi Square
•Fisher’s Exact Test negative academic and career outcomes.
•Analysis of Variance
•Logistic Regression
LIMITATIONS
Single institution data
Identification of medical students and physicians may not be inclusive of all who require remediation