Resident Perspectives on Remediation: A Qualitative Study Informing a Learner‑Centered Model in Pediatric Residency...

Remediation is not uncommon in graduate medical education; however, the literature on this topic is limited. Existing literature focuses on supporting program directors (PDs) who encounter learners facing difficulty with performance competencies. We previously developed a stepwise framework to support pediatric PDs through the process of remediation based on a national survey. However, this model did not incorporate the perspective of residents who had undergone remediation. The goal of this national, qualitative study was to understand the experiences of residents who had undergone remediation to better inform a model of effective resident remediation.

In 2024, we conducted semi-structured interviews with pediatric residents who had undergone remediation. De-identified transcripts were inductively analyzed using grounded theory. Themes were then compared to our theoretical framework of effective remediation from program director's perspectives.

Thematic saturation was achieved after eight interviews; eleven total residents were interviewed as part of this study. The five main themes identified by residents focused on the inadequacy of feedback systems, the lack of transparency and personalization during the remediation process, and the impact this process has on a resident's emotional well-being and future career.

Through interviewing residents who had undergone remediation, we learned that they prefer transparent and personalized remediation processes that promote psychological safety, and that these qualities are imperative to a successful remediation process. This informed an updated conceptual model for remediation, which proposes actionable steps for the remediation process across graduate medical education.