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Remediation in Medical Education
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Table of Contents

Part I: Overview and Framing.- Chapter 1: Remediation: The Measure of a Profession.- Chapter 2: Toward a Programmatic Approach for Remediation: Evidence-based Goals for Institutions.- Chapter 3: Diversity, Inclusion, and Remediation: Excellence Requires Equity.- Chapter 4: The Metacognitive Competency: Becoming a Master Adaptive Learner.- Chapter 5: The Learner’s Experience of Remediation.- Chapter 6: A Stepwise Approach to Remediation for the Frontline Clinician-Educator.- Part II: Remediation by Competency.- Chapter 7: “They Need to Read More”: Helping Trainees who Struggle with Knowledge Base.- Chapter 8: Remediation of Physical Examination Skills.- Chapter 9: Assessment and Remediation of Clinical Reasoning.- Chapter 10: Remediation for Technical Skills.- Chapter 11: Evaluation and Remediation of Organization, Efficiency, and Time Management.- Chapter 12: Remediation of Interpersonal and Communication Skills.- Chapter 13: Professionalism Lapses as Professional Identity FormationChallenges.-  Chapter 14: Nuts and Bolts of Professionalism Remediation.- Chapter 15: Reflection and Narrative in Remediation.- Chapter 16: Remediation Through the Lens of Systems-Based Practice and Practice-Based Learning and Improvement.- Part III: Special Topics.- Chapter 17: Learning Differences and Medical Education.- Chapter 18: Trainee Well-being and Remediation. - Chapter 19: Faculty Development: Preparing to Conduct Remediation.- Part IV: Systems, Legal, and Ethical Considerations – Undergraduate Medical Education and Interprofessional Schools.- Chapter 20: The View from Three Medical School Dean’s Offices.- Chapter 21: Commentary From A Brazilian Medical Professor.- Chapter 22: Commentary from the University of Minnesota Bachelor of Science in Nursing (BSN) Program.- Chapter 23: Commentary from the Nell Hodgson Woodruff School of Nursing, Emory University.- Chapter 24: Commentary from the Purdue University College of Pharmacy.- Chapter 25: Commentary from the School ofPhysical Therapy, University of California, San Francisco.- Part V: Systems, Legal, and Ethical Considerations – Graduate Medical Education.- Chapter 26: The View from the Office of the Designated Institutional Officer (DIO), Washington University in St. Louis.- Chapter 27: Commentary from the Oman Medical Specialty Board.- Chapter 28: Commentary from the National Healthcare Group Family Medicine Residency, Singapore.- Section VI: Systems, Legal, and Ethical Considerations – Preparing for Dismissal.- Chapter 29: When the Prognosis is Poor: Documentation, The Law, and When and How to Give Up.- Epilogue: A Student’s Perspective on RemediationPart I: Overview and Framing.- Chapter 1: Remediation: The Measure of a Profession.- Chapter 2: Toward a Programmatic Approach for Remediation: Evidence-based Goals for Institutions.- Chapter 3: Diversity, Inclusion, and Remediation: Excellence Requires Equity.- Chapter 4: The Metacognitive Competency: Becoming a Master Adaptive Learner.- Chapter 5:The Learner’s Experience of Remediation.- Chapter 6: A Stepwise Approach to Remediation for the Frontline Clinician-Educator.- Part II: Remediation by Competency.- Chapter 7: “They Need to Read More”: Helping Trainees who Struggle with Knowledge Base.- Chapter 8: Remediation of Physical Examination Skills.- Chapter 9: Assessment and Remediation of Clinical Reasoning.- Chapter 10: Remediation for Technical Skills.- Chapter 11: Evaluation and Remediation of Organization, Efficiency, and Time Management.- Chapter 12: Remediation of Interpersonal and Communication Skills.- Chapter 13: Professionalism Lapses as Professional Identity Formation Challenges.- Chapter 14: Nuts and Bolts of Professionalism Remediation.- Chapter 15: Reflection and Narrative in Remediation.- Chapter 16: Remediation Through the Lens of Systems-Based Practice and Practice-Based Learning and Improvement.- Part III: Special Topics.- Chapter 17: Learning Differences and Medical Education.- Chapter 18: Trainee Well-being and Remediation.- Chapter 19: Faculty Development: Preparing to Conduct Remediation.- Part IV: Systems, Legal, and Ethical Considerations – Undergraduate Medical Education and Interprofessional Schools.- Chapter 20: The View from Three Medical School Dean’s Offices.- Chapter 21: Commentary From A Brazilian Medical Professor.- Chapter 22: Commentary from the University of Minnesota Bachelor of Science in Nursing (BSN) Program.- Chapter 23: Commentary from the Nell Hodgson Woodruff School of Nursing, Emory University.- Chapter 24: Commentary from the Purdue University College of Pharmacy.- Chapter 25: Commentary from the School of Physical Therapy, University of California, San Francisco.- Part V: Systems, Legal, and Ethical Considerations – Graduate Medical Education.- Chapter 26: The View from the Office of the Designated Institutional Officer (DIO), Washington University in St. Louis.- Chapter 27: Commentary from the Oman Medical Specialty Board.- Chapter 28: Commentary from theNational Healthcare Group Family Medicine Residency, Singapore.- Section VI: Systems, Legal, and Ethical Considerations – Preparing for Dismissal.- Chapter 29: When the Prognosis is Poor: Documentation, The Law, and When and How to Give Up.

About the Author

Adina Kalet, MD, MPH, is the Stephen and Shelagh Roell Endowed Chair and Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education at the Medical College of Wisconsin. Prior to this she spent 32 years at New York University School of Medicine ending as a tenured Professor of Medicine and Surgery and Co-Director of the Program on Medical Education Innovation and Research (PrMEIR). The mission of PrMEIR is to advance medical education scholarship and to institute best practices for patient-centered, evidence-based medical education. She led the Research on Medical Education Outcomes (ROMEO) unit of PrMEIR, as part of the Section of Primary Care, Division of General Internal Medicine, and Department of Medicine. ROMEO is a group of dedicated cross-disciplinary researchers seeking to link education and health services research methodology to study how educational interventions lead to long-term outcomes in learners and patients. Forthe past 10 years Dr. Kalet has directed the NYU Clinical Translational Science Institute Translational Research Education and Careers Mentor Development Program (NYU CTSI TREC MDP), which prepared 15-20 researchers annually for their role in mentoring translational research. She has held the Arnold P. Gold Professor of Humanism and Professionalism, practiced and taught primary care medicine in the urban inner city, has been the PI or program director on a number of cross-disciplinary and multi-institutional curriculum development and research grants. Dr. Kalet has written extensively on issues of clinical skills evaluation and remediation, faculty development and mentoring, professional identity development assessment and psychosocial aspects of medicine. She has been primary mentor on federal Career Development Awards, numerous Master’s Theses and countless mentoring committees. In 2012-2013 she took a sabbatical during which she wrote a book entitled Remediation in Medical Education: A Midcourse Correction (Springer).  In this book she brought relevant theory and practice from multiple scholarly domains to bear on the challenges of ensuring health professional trainees are fully competent to practice medicine. Dr. Kalet splits her time between her new home in Milwaukee and her long-time home in Brooklyn NY with her husband Mark and their two children (and two cats).

Calvin Chou, MD, PhD is Professor of Clinical Medicine at the University of California at San Francisco, and staff physician at the Veterans Affairs Health Care System in San Francisco. After undergraduate work at Yale, he received his PhD in microbiology and his MD at Columbia University, and subsequently completed residency training in internal medicine at UCSF.  As Senior Faculty Advisor for External Education with the Academy of Communication in Healthcare, he is recognized internationally for leading workshops in relationship-centered communication, feedback, conflict, and remediation in health professions education. Currently he is director of VALOR, a longitudinal program based at the VA that emphasizes humanistic clinical skill development for medical students. He also held the first endowed Academy Chair in the Scholarship of Teaching and Learning at UCSF.  He has delivered communication skills curricula for providers at health systems across the country, including Mayo Clinic, Cleveland Clinic, Stanford Health, New York Presbyterian, Baylor Scott & White, Wake Forest, and Texas Children’s Hospital, and internationally as well.  His research interests include assessment of curricular developments in clinical skills and clinical skills remediation, forces influencing feedback in health sciences education, and enhancing communication for interprofessional trainees.  He is co-editor of the books Remediation in Medical Education: A Midcourse Correction, and Communication Rx: Transforming Healthcare Through Relationship-Centered Communication.

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