Faculty Development for Medical Educators

Who is The Struggling Learner?

• A learner whose academic performance is significantly below performance potential because of a specific affective, cognitive, structural, or interpersonal difficulty. (Vaughn et al. 1998) 
• A student or resident who does not meet the expectations of the training program because of a significant problem with knowledge, attitudes or skills.  (Y. Steinert BMJ 2008)

The Importance of Recognizing Struggling Learners

MOST students will struggle at some point throughout their medical training. 

There are MANY factors that may impact a student’s performance.

• medical knowledge
• professionalism
• work-life balance
• interpersonal stress
• mental/emotional health crises

These factors affect both pre-clinical and clinical learners.

Students struggles are USUALLY NOT due to knowledge deficit.  The factors listed above are IMPACTING the LEARNING PROCESS.

Identifying Specific Deficits

Most students have more than 1 deficit/target area for improvement.

Use multiple methods to identify specific deficits:

• Direct observations
• Learner interviews
• Multisource feedback
• Written examinations
• Employee health/psychiatric evaluations
• Evaluation with coach/mentor

Process for Feedback

• Set-up - Request to meet with student.
• Observation - Share specific information/observations.
• Feedback Delivery - Ask questions; hear learner’s perspective; share yours.
• Accountability/Next steps - Make a plan; follow up. 

Motivational Interviewing

• Collaborative conversation style
• Strengthening a person’s own motivation and commitment to change
• Focus on guiding rather than directing

Introduction

Remediation - correction of the underlying deficit.

Effective Remediation Includes: Deliberate Practice Feedback Reflection Ongoing Reassessment It is a continuous sequence in any direction.

Effective Systematic Approach to Learner Remediation

• A consistent system of identification
• A diagnostic team – “Assessment Team”
• Faculty development 
• An implementation team – “Success Team”
• Measurable outcomes
• Institutional resources
• Established policies & procedures 

More Frequent Low-Stakes Formative Assessments

• Monitor learners' progress.
  • This should be ongoing.
  • You should identify struggling learners as early as possible.

Incorporate Various Strategies With Emphasis on Process of Learning

• Use formative and summative assessments.

Develop Remedial Plans to Address Specific Performance Areas

• It should be learner centered.
• Students should take accountability.  

Assessment Methods as Strategies for Learner Remediation 

• Formative portfolio
• Narrative assessment (self; faculty; peer)
• Personal evaluation and reflection
• Concept Mapping/Slide presentations
• Patient logs; preceptor feedback
• OSCE checklists
• TBL and PBL

Below are resources related to remediation.