Table 2.

Summary of guidelines for remediation in medical education

Guideline	Systems level, Do’s	Recommendation
1	Do advertise to the entire medical education community that learners commonly need remediation, which is resourced and available to all learners	Tentative
2	Do develop a robust feedback culture that impels learner improvement	Moderate
3	Do align selection and assessment systems with desired outcomes and graduate qualities	Strong
4	Do construct strategies aimed at averting the need for remediation	Strong
5	Do deliver remediation as highly individualized processes while recognizing common patterns across struggling learners	Moderate
6	Do ‘feed forward’ remediation information, with an abundance of caution	Moderate
7	Do provide faculty development and tangible support for frontline educators in early identification of, effective interventions for, and appropriate referral of struggling learners	Tentative
8	Do separate the individuals conducting the remediation process from those who determine the outcome of remediation	Tentative
9	Do ensure due process, balancing empathy for individual students’ struggles with the medical profession’s responsibility to society	Moderate
10	Do create compassionate alternative pathways for those who do not choose to or cannot complete medical training	Tentative
	Remediation process, Do’s
11	Do aim to detect a need for remediation early	Moderate
12	Do collect relevant data from multiple sources across case content	Strong
13	Do explore multiple causes of learner struggle beyond educational or workplace issues	Strong
14	Do intervene proactively with struggling learners—do not rely on their initiative	Strong
15	Do have trainees in remediation undergo intensive, longitudinal tutoring with emphasis on study skills, collaboratively designed plans, frequent high-quality feedback, and individualized assessment	Strong
16	Do assess for and improve skills in learning self-regulation	Strong
17	Do remediate knowledge and skills in small groups with expert facilitators	Moderate
18	Do follow up with learners, even after the presumed end of the remediation period	Moderate
	Don’ts
19	Don’t rely solely on traditional academic markers of performance	Moderate
20	Don’t merely give more time, repeat the learner experience, give general or vague advice, or just ‘teach to the test’ without additional support	Strong
	Don’t knows
21	What are the long-term outcomes of remediation?
22	What is the optimal blend and duration of remediation?
23	How does remediation fit with CBME and its approach of learner-centredness and de-emphasis of time?
24	What is the optimal balance between the benefits of educational handovers and the need to protect learners from negative bias that may arise from such handovers?
25	What specific measures predict the need for remediation?
26	Apart from establishing a longitudinal remediation program (Guideline 15), what are the most effective remediation practices?