Remediation in Medical Education

Adina L. Kalet, MD, MPH is a Professor of Medicine and Surgery at New York University and has conducted vast amounts of research on medical education over the course of her career. She is a member of the Society of General Internal Medicine and was recognized in 2008 with their National Award for Scholarship in Medical Education. She has directed the Primary Care Internal Medicine Residency, Medical Education for the Division of Primary Care, the Macy Initiative in Health Communication, and the Dean's Task Force on Clinical Assessment, all at NYU. She has also served as a Principal Investigator for the NYS Department of Health's project on medical school participation in ambulatory care and the co-director for the CDC's course on preparing primary care physicians for the psychosocial aspects of bioterrorism. Calvin Chou, MD, PhD is Professor of Clinical Medicine at UCSF, and staff physician at the VA Medical Center in San Francisco. As a faculty member of the American Academy on Communication in Healthcare, he is nationally recognized for his efforts in education and research to enhance communication between patients and physicians. Currently he is director of VALOR, an innovative longitudinal program based at the VA that emphasizes humanistic clinical skill development for medical students. He also holds the first endowed Academy Chair in the Scholarship of Teaching and Learning at UCSF. He has delivered communication skills curricula for providers at medical centers across the country, including Mayo Clinic, Cleveland Clinic Foundation, Stanford University, and New York University.

Table of Contents

 Part I: Presenting Problems and Symptoms Leading to Remediation

Chapter 1. Defining and Assessing Competence        

Adina Kalet and Martin Pusic

Chapter 2. An Example of a Remediation Program     

Adina Kalet, Linda Tewksbury, Jennifer Ogilvie, Sandra Yingling

Chapter 3. “She Needs to Read More”: Helping trainees who struggle with medical knowledge

Jeannette Guerrasio

Chapter 4. Remediation of Interpersonal and Communication Skills         

Calvin Chou, James Bell, Carol Chou, and Anna Chang

Chapter 5. Remediation of Physical Exam Skills         

Tahlia Spector and Cha-Chi Fung

Chapter 6. Assessing and Remediating Clinical Reasoning         

Andrew Mutnick and Michael Barone

Chapter 7. Remediating Lapses in Professionalism     

Muriel J Bebeau and Kathy Faber-Langendoen

Part II: Contextual Factors

Chapter 8. “You said, I heard”: Speaking the subtext in interracial conversations  

Elizabeth Brondolo and Kristy-Lee Jean-Pierre

Chapter 9. Learning Differences and Medical Education 

Paul Yellin

Chapter 10. “Well, This Is Awkward”: Autism Spectrum Disorder in Medical Trainees         

Sandra Yingling

Chapter 11. Stress and Distress and Wellness            

Sarah Williams

Chapter 12. Perspectives from a Psychiatrist in an Office of Advising Resources

Laurie Raymond

Part III: Resources

Chapter 13. The Metacognitive Competency: The key to life-long learning           

Mark Quirk

Chapter 14. Use of reflection as a remediation tool     

David Hatem

Chapter 15. Feedback                                                

Denise Connor, Calvin Chou, and Denise Davis

Chapter 16. Appreciative coaching: A positive process for remediation   

Maysel Kemp White and Peter Barnett

Part IV: Systems Viewpoint

Chapter 17. Preparing Program Directors to address unprofessional behavior     

Eve Caligor, Ze’ev Levin, and Emily Deringer

Chapter 18. The view from the Dean’s office               

Lynn Buckvar-Keltz

Chapter 19. Preparing to conduct remediation             

Adina Kalet and Sondra Zabar

Chapter 20. “The Prognosis is Poor”: When to give up 

Jeannette Guerrasio

Chapter 21. A Research Agenda for the Field of Remediation     

Calvin Chou, Adina Kalet, Karen Hauer

Chapter 22: Epilogue: A Student’s Perspective on Remediation

David Tawfik

Appendix A: Contributor Biographies