This study analyzed data from 151 medical students and physicians referred for remediation at the University of Colorado from 2006-2012. The results showed that the type of deficit requiring remediation varied depending on level of training, with medical students most commonly struggling with mental well-being. Certain deficits such as difficulties with interpersonal skills or professionalism were associated with increased risk of not matching to a residency or probation. The amount of faculty time dedicated to remediation decreased the likelihood of probation or negative academic outcomes.

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