Got SPIRiT?: Evaluating a Supportive Approach to Medical Resident Remediation

Up to 15% of family medicine residents undergo remediation. While frequently successful, remediation can be emotionally challenging.

We developed a remediation approach called SPIRiT: Support, Processing emotions, Individualized plan, Reducing stigma/scrutiny, "i" (minimizing ego), and Transparency. A multidisciplinary team implemented SPIRiT. Qualitative researchers analyzed participant interviews using an inductive approach.

Five residents completed interviews. Three categories were identified: understanding remediation, having agency, and processing and integrating feedback. Some residents were surprised they needed remediation and were unclear about remediation duration. Residents appreciated confidentiality and the opportunity to provide input. Processing feedback was emotionally challenging. Support from the behavioral health faculty member and peers who had completed remediation was helpful.

The SPIRiT approach provides a helpful framework to improve resident remediation through multidisciplinary support, opportunities for emotional processing, and meaningful learner involvement.