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. 2022 Apr 20;22(1):294.
doi: 10.1186/s12909-022-03278-x.

Post graduate remediation programs in medicine: a scoping review

Clarissa Wei Shuen Cheong  1   2 , Elaine Li Ying Quah  1   2 , Keith Zi Yuan Chua  1   2 , Wei Qiang Lim  1   2 , Rachelle Qi En Toh  1   2 , Christine Li Ling Chiang  1   2 , Caleb Wei Hao Ng  1   2 , Elijah Gin Lim  1   2 , Yao Hao Teo  1   2 , Cheryl Shumin Kow  1   2 , Raveendran Vijayprasanth  1   2 , Zhen Jonathan Liang  1   2 , Yih Kiat Isac Tan  1   2 , Javier Rui Ming Tan  1   2 , Min Chiam  3 , Alexia Sze Inn Lee  3 , Yun Ting Ong  1   2 , Annelissa Mien Chew Chin  4 , Limin Wijaya  5   6 , Warren Fong  1   5   7 , Stephen Mason  8 , Lalit Kumar Radha Krishna  9   10   11   12   13   14   15
Affiliations

Post graduate remediation programs in medicine: a scoping review

Clarissa Wei Shuen Cheong et al. BMC Med Educ. .

Abstract

Background: Recognizing that physicians may struggle to achieve knowledge, skills, attitudes and or conduct at one or more stages during their training has highlighted the importance of the 'deliberate practice of improving performance through practising beyond one's comfort level under guidance'. However, variations in physician, program, contextual and healthcare and educational systems complicate efforts to create a consistent approach to remediation. Balancing the inevitable disparities in approaches and settings with the need for continuity and effective oversight of the remediation process, as well as the context and population specific nature of remediation, this review will scrutinise the remediation of physicians in training to better guide the design, structuring and oversight of new remediation programs.

Methods: Krishna's Systematic Evidence Based Approach is adopted to guide this Systematic Scoping Review (SSR in SEBA) to enhance the transparency and reproducibility of this review. A structured search for articles on remediation programs for licenced physicians who have completed their pre-registration postings and who are in training positions published between 1st January 1990 and 31st December 2021 in PubMed, Scopus, ERIC, Google Scholar, PsycINFO, ASSIA, HMIC, DARE and Web of Science databases was carried out. The included articles were concurrently thematically and content analysed using SEBA's Split Approach. Similarities in the identified themes and categories were combined in the Jigsaw Perspective and compared with the tabulated summaries of included articles in the Funnelling Process to create the domains that will guide discussions.

Results: The research team retrieved 5512 abstracts, reviewed 304 full-text articles and included 101 articles. The domains identified were characteristics, indications, frameworks, domains, enablers and barriers and unique features of remediation in licenced physicians in training programs.

Conclusion: Building upon our findings and guided by Hauer et al. approach to remediation and Taylor and Hamdy's Multi-theories Model, we proffer a theoretically grounded 7-stage evidence-based remediation framework to enhance understanding of remediation in licenced physicians in training programs. We believe this framework can guide program design and reframe remediation's role as an integral part of training programs and a source of support and professional, academic, research, interprofessional and personal development.

Keywords: Education; Medical; Physicians in training; Postgraduate physicians; Remediation; Surgical; Systematic scoping review.

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Conflict of interest statement

All authors have no competing interests.

Figures

Fig. 1
Fig. 1
The SEBA process
Fig. 2
Fig. 2
PRISMA Flowchart
Fig. 3
Fig. 3
A 7-stage remediation framework built upon Taylor and Hamdy [160]‘s Multi-theories Model of Adult Learning and Hauer, Ciccone [62]‘s remediation framework
See this image and copyright information in PMC

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