Thin Line of Remediation in PA Education

 
Student Remediation
 
Rachel Carlson
Jeanie McHugo
 
Program Directors Workshop 101
 
R
e
m
e
d
i
a
t
i
o
n
 
PA faculty are often challenged to manage the thin line between
remediation and “spoon feeding”. In this session, participants will
explore the relationship between institutional missions, principles
of pedagogy, and remediation.
By the end of this session, learners will be able to:
 
Define remediation
Analyze remediation goals
Describe how remediation goals relate to PA education and the
mission of a program
 
W
h
a
t
 
?
 
 
The act or process of remedying something that is
undesirable or deficient.
 
An intervention to avert a potentially poor situation or
outcome
 
 
 
 
 
 
 
 
 
"Remediation." Thefreedictionary.com, n.d. June. 2015.
http://www.thefreedictionary.com/remediation
 
W
h
y
 
R
e
m
e
d
i
a
t
e
 
P
r
o
 
 
Second opportunity
Fast paced curriculum w/ high
stakes
Vast curricula content
Increase access to the
profession/ diversity of
perspectives
Required (?)
Other?
 
C
o
n
 
 
Perceived as “spoon feeding”;
creates an unrealistic condition
Creates a two-tier system
Promotes concept of second
chances Unfair/biased
Other?
 
A
R
C
 
P
A
A
c
c
r
e
d
i
t
a
t
i
o
n
 
S
t
a
n
d
a
r
d
s
 
C3.03 The program must monitor and document the progress of
each student in a manner that promptly identifies deficiencies in
knowledge or skills and establishes means for remediation.
 
G
u
i
d
i
n
g
 
P
r
i
n
c
i
p
l
e
s
 
 
 
 
 
Assess institutional principles
Decide, in advance
If yes, under what conditions
If no, state clearly
Align policies and procedures with institutional principles
 
(the program is the institution)
 
D
e
f
i
n
e
 
R
e
m
e
d
i
a
t
i
o
n
 
G
o
a
l
s
 
 
 
 
Address potential outcome of at risk students
Supplement students facing multiple competing demands
Supplement those with varied learning and integration capacities
 
W
h
a
t
 
m
a
y
 
b
e
 
r
e
m
e
d
i
a
t
e
d
?
 
Didactic exams
Expository papers
Direct observation and simulation exams
Clinical experience/clerkship performance
Professionalism ratings
 
C
o
n
d
i
t
i
o
n
s
 
 
 
W
h
e
n
 
m
i
g
h
t
 
r
e
m
e
d
i
a
t
i
o
n
 
b
e
 
a
n
 
o
p
t
i
o
n
?
 
Assessed performance falls within a defined number of points or percent
score, required for passing
On one assessment, more than one, any or all?
In one, in any course or in all courses
In didactic phase, clinical phase or both
 
F
o
r
 
W
h
o
m
?
 
 
 
Remediation is not an ADA accommodation
If in policy, conditions and procedures for implementation must be
specified and available 
to all
 
A
D
A
 
A
c
c
o
m
m
o
d
a
t
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w
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,
 
s
p
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n
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(
s
)
.
 
R
e
m
e
d
i
a
t
i
o
n
 
S
t
r
a
t
e
g
i
e
s
 
 
 
Clinical activities
Independent study
Precepted, exam review
Organized group activities for deficits in history-taking, physical
examination, knowledge, clinical reasoning, professionalism, and
communication
Additional assessments (re-exams)
Multilayered assessments
 
I
m
p
l
e
m
e
n
t
a
t
i
o
n
 
 
Involve students in their remediation plan or student may propose a
plan
Identify common steps and resources that can be used for different
levels of remedial study.
Determine success factors
Communicate the plan in writing, sign and file
Hold a faculty student conference to go over the details and
expectations, including time line and deal breakers.
 
S
i
g
n
a
t
u
r
e
 
R
e
q
u
i
r
e
d
 
Document, sign and file
Make it official
 
Remediation Policy Template
(example)
 
Definition of Remediation
Remediable competencies
Types of Remediation levels
Self, Course Exam/Assignment, Course/Program Level
Remediation Activities
Evaluation tool
 
Remediation Exercise
(Case Studies)
 
 
P
i
t
f
a
l
l
s
 
t
o
 
A
v
o
i
d
 
Subjectivity
Personality based
Poorly defined expectations
Poor monitoring and follow through
Other potential problems
 
I
n
 
s
u
m
m
a
r
y
,
 
Assess and determine if remediation is an option
 
Establish policies and procedures that define the goals,
conditions, expectations and outcome
 
R
e
f
e
r
e
n
c
e
s
 
 
ARC-PA Standards for Accreditation, 4
th
 edition
 
Cleland J, Leggett H, Sandars, J et al. The remediation challenge: Theoretical and methodological
insights from a systematic review
. Medical Education
, 2013: 47, 242-251. 
doi:10.1111/medu.12052
 
Does remediation work for all students? How the effects of postsecondary remedial and
developmental courses vary by level of academic preparation. An NCPR Working Paper National
Center for Postsecondary Research. 
Teachers College, Columbia University
, : 2010-Sep
 
Ending college remediation: Consequences for access and opportunity.
http://files.eric.ed.gov/fulltext/ED530578.pdf
 
Hauer KE, Ciccone A, Henzel TR et al. Remediation of the deficiency of physicians across the
continuum from medical school to practice: a thematic review of the literature. 
Academic Medicine,
2009: 84, 1822-1832.
 
Makhani L, Bradley R, Wong J et al. A framework for successful remediation within allied health
programs: strategies based on existing literature
. J Med Imaging Rad Science
, 2012: 43, 112-120. 
doi:
10.1016/j.jmir.2011.12.006
 
Saxena V, O'Sullivan PS, Teherani A, Irby DM, Hauer KE. Remediation techniques for student
performance problems after a comprehensive clinical skills assessment
. 
Acad Med
.
 2009
May;84(5):669-76. doi: 10.1097/ACM.0b013e31819fa832.
 
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Explore the challenges and goals of remediation in physician assistant (PA) education, delving into the importance of addressing deficiencies while avoiding spoon-feeding. Learn how to align institutional principles with remediation strategies to provide second chances for students with diverse needs and backgrounds.

  • Remediation
  • Physician Assistant Education
  • Institutional Principles
  • Student Support
  • Academic Standards

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  1. 2017 PAEA Workshops Program Directors Workshop 101 Student Remediation Rachel Carlson Jeanie McHugo

  2. Remediation PA faculty are often challenged to manage the thin line between remediation and spoon feeding . In this session, participants will explore the relationship between institutional missions, principles of pedagogy, and remediation. By the end of this session, learners will be able to: Define remediation Analyze remediation goals Describe how remediation goals relate to PA education and the mission of a program

  3. What ? The act or process of remedying something that is undesirable or deficient. An intervention to avert a potentially poor situation or outcome "Remediation." Thefreedictionary.com, n.d. June. 2015. http://www.thefreedictionary.com/remediation

  4. Why Remediate Pro Con Second opportunity Fast paced curriculum w/ high stakes Vast curricula content Increase access to the profession/ diversity of perspectives Required (?) Other? Perceived as spoon feeding ; creates an unrealistic condition Creates a two-tier system Promotes concept of second chances Unfair/biased Other?

  5. ARC PA Accreditation Standards C3.03 The program must monitor and document the progress of each student in a manner that promptly identifies deficiencies in knowledge or skills and establishes means for remediation.

  6. Guiding Principles Assess institutional principles Decide, in advance If yes, under what conditions If no, state clearly Align policies and procedures with institutional principles (the program is the institution)

  7. Define Remediation Goals Address potential outcome of at risk students Supplement students facing multiple competing demands Supplement those with varied learning and integration capacities

  8. What may be remediated? Didactic exams Expository papers Direct observation and simulation exams Clinical experience/clerkship performance Professionalism ratings

  9. Conditions When might remediation be an option? Assessed performance falls within a defined number of points or percent score, required for passing On one assessment, more than one, any or all? In one, in any course or in all courses In didactic phase, clinical phase or both

  10. For Whom? Remediation is not an ADA accommodation If in policy, conditions and procedures for implementation must be specified and available to all ADA Accommodation-special intervention for individuals with documented, special need (s).

  11. Remediation Strategies Clinical activities Independent study Precepted, exam review Organized group activities for deficits in history-taking, physical examination, knowledge, clinical reasoning, professionalism, and communication Additional assessments (re-exams) Multilayered assessments

  12. Implementation Involve students in their remediation plan or student may propose a plan Identify common steps and resources that can be used for different levels of remedial study. Determine success factors Communicate the plan in writing, sign and file Hold a faculty student conference to go over the details and expectations, including time line and deal breakers.

  13. Signature Required Document, sign and file Make it official

  14. Remediation Policy Template (example) Definition of Remediation Remediable competencies Types of Remediation levels Self, Course Exam/Assignment, Course/Program Level Remediation Activities Evaluation tool

  15. Remediation Exercise (Case Studies)

  16. Pitfalls to Avoid Subjectivity Personality based Poorly defined expectations Poor monitoring and follow through Other potential problems

  17. In summary, Assess and determine if remediation is an option Establish policies and procedures that define the goals, conditions, expectations and outcome

  18. References ARC-PA Standards for Accreditation, 4thedition Cleland J, Leggett H, Sandars, J et al. The remediation challenge: Theoretical and methodological insights from a systematic review. Medical Education, 2013: 47, 242-251. doi:10.1111/medu.12052 Does remediation work for all students? How the effects of postsecondary remedial and developmental courses vary by level of academic preparation. An NCPR Working Paper National Center for Postsecondary Research. Teachers College, Columbia University, : 2010-Sep Ending college remediation: Consequences for access and opportunity. http://files.eric.ed.gov/fulltext/ED530578.pdf Hauer KE, CicconeA, Henzel TR et al. Remediation of the deficiency of physicians across the continuum from medical school to practice: a thematic review of the literature. Academic Medicine, 2009: 84, 1822-1832. Makhani L, Bradley R, Wong J et al. A framework for successful remediation within allied health programs: strategies based on existing literature. J Med Imaging Rad Science, 2012: 43, 112-120. doi: 10.1016/j.jmir.2011.12.006 Saxena V, O'Sullivan PS, Teherani A, Irby DM, Hauer KE. Remediation techniques for student performance problems after a comprehensive clinical skills assessment. Acad Med. 2009 May;84(5):669-76. doi: 10.1097/ACM.0b013e31819fa832.

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