4. 1. Define the resident who needs remediation 2. Recognize a four step approach to remediation 3. Apply these steps to a struggling resident

5.  The act or process of correcting a fault or deficiency  Questions: 1. Which residents have faults or deficiencies? 2. Do they ALL need remediation?

6.  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?

7.  Exceptionally bright  Organized and responsible  Gets along well with everyone  Develops an intention tremor  Does she need remediation?

8.  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?

9.  The act or process of correcting a fault or deficiency  It is done in as organized and objective fashion as possible

10. a.Competence assessment b. Diagnosis of deficiency and development of individualized learning plans c. Instruction/remediation with deliberate practice, feedback, and reflection d. Focused reassessment and certification of competence Acad Med:84(12);1822-32

11.  Requires reliable and valid assessment tools  ACGME toolbox of assessment methods  May need outside help

12.  Based on assessment tools used  Based on deficiency needing remediation  Based on individual being remediated  Based on resources

13.  Activities need to address deficiencies  Provide opportunity for deliberate practice, feedback, and reflection

14.  Reassess for progress  Continuously  End of remediation period  Can use same modalities as for diagnosis  Can use more focused tools

15.  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

16. PROGRAM DIRECTOR EDITION

17.  Two cases  Group effort  Goals: 1. Work through the steps of each remediation 2. Focus on the practicalities 3. We will provide guidance and role play the personnel

19.  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