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Published on: October 6, 2022
The remediation challenge: theoretical and methodological insights from a systematic review
Jennifer Cleland1, Heather Leggett, John Sandars
1Division of Medical and Dental Education, University of Aberdeen, Aberdeen, UK. jen.cleland@abdn.ac.uk
Remediation for underperforming medical trainees often focuses on passing exams, but evidence on its effectiveness is unclear. More research is needed to understand how best to support learning and improve outcomes for struggling medical students.
Area of Science:
- Medical Education
- Health Professions Education Research
- Educational Psychology
Background:
- Remediation is a common intervention for medical students and doctors who perform poorly on assessments.
- Existing evidence on the effectiveness of remediation strategies is conflicting and uncertain.
- There is a need to understand the mechanisms and components of successful remediation.
Purpose of the Study:
- To systematically review and synthesize evidence on the effectiveness of remediation interventions in medical education.
- To identify how and why remediation strategies may or may not be effective.
- To inform future development and evaluation of remediation programs.
Main Methods:
- A comprehensive search of six major academic databases (MEDLINE, EMBASE, CINAHL, ERIC, Web of Science, Scopus) was conducted for studies published between 1984 and April 2012.
- Inclusion criteria required studies to involve an intervention, provide retest data, and report outcomes related to satisfaction, knowledge, skills, or patient effects.
- Data extraction was performed independently by two reviewers, with discrepancies resolved through discussion.
Main Results:
- Thirty-one studies met the review criteria, with most published after 2000 and targeting medical students for immediate examination improvement.
- Few studies included control groups, conceptual frameworks, adequate sample sizes, or long-term follow-up; improvements were not sustained in those that did.
- Intervention designs were often complex, but lacked reporting detail to identify active components.
Conclusions:
- Current remediation in medical education primarily aims at passing re-examinations, offering little insight into effective learning support.
- More recent studies show better quality, but rigorous approaches to developing and evaluating remediation are still necessary.
- Further research should focus on understanding the 'how' and 'why' of remediation to enhance learning and professional development.
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