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Individualized remediation during fellowship training.

J William Sparks1, Mary Landrigan-Ossar1, Amy Vinson1

  • 1The Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115.

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Summary

Pediatric anesthesia programs can improve fellow performance with a structured remediation protocol. This individualized remediation program (IRP) ensures fellows meet competency standards for independent practice.

Keywords:
Graduate medical trainingMedical professional evaluationMedical trainee feedbackRemediation

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Area of Science:

  • Medical Education
  • Anesthesiology
  • Physician Training

Background:

  • Accreditation Council for Graduate Medical Education mandates performance monitoring for medical trainees.
  • Programs must address deficiencies and ensure physicians develop independent practice attributes.

Purpose of the Study:

  • To describe the implementation and outcomes of a revised evaluation policy and remediation protocol for pediatric anesthesia fellows.
  • To assess the effectiveness of an individualized remediation program (IRP) in addressing performance deficiencies.

Main Methods:

  • Instituted a revised evaluation policy and remediation protocol in 2008.
  • Implemented individualized remediation programs (IRPs) involving formal reviews, written contracts, and time-based goals.
  • Utilized multimodality, daily evaluations, and group discussions within a Clinical Competency Committee.

Main Results:

  • Seven out of 130 (5%) pediatric anesthesia fellows required formal consultation for performance or behavioral deficiencies.
  • Four fellows participated in the individualized remediation program (IRP).
  • All fellows who underwent the IRP successfully completed their training and achieved board certification.

Conclusions:

  • The individualized remediation program (IRP) is an effective strategy for improving fellow performance in pediatric anesthesiology.
  • This structured approach ensures fellows acquire the necessary skills and behaviors for independent practice.
  • The multimodality and time-based evaluations within the IRP contribute to successful outcomes.