Acad Med. 2026 Mar 11:wvag058. doi: 10.1093/acamed/wvag058. Online ahead of print.
ABSTRACT
PURPOSE: This study investigates current remediation practices in US internal medicine (IM) clerkships, focusing on how clerkship directors (CDs) identify, diagnose, remediate, and reassess struggling students, and explores strategies for improving remediation processes in undergraduate medical education.
METHOD: Study data derive from an annually recurring, nationally representative survey of IM core CDs at 140 fully and provisionally Liaison Committee on Medical Education-accredited schools fielded from September to December 2023. One section included 16 questions on identification of struggling learners and remediation strategies for IM clerkship students. Quantitative data were analyzed using descriptive statistics. Free-text responses were analyzed using qualitative inductive content analysis.
RESULTS: A total of 118 of 140 CDs (84%) responded to the survey section that informed this study. These CDs reported that students most frequently had deficiencies in test-taking (72 [61%]), differential diagnosis generation (70 [59%]), oral presentations (67 [57%]), and time management (61 [52%]). Deficiencies were identified in multiple ways, most frequently through faculty communication (76 [64%]), shelf examination performance (74 [63%]), and narrative evaluations (70 [59%]), but only 26 CDs (22%) thought that struggling students were identified early enough to initiate remediation during clerkship. The most commonly reported remediation method was retaking a failed examination without other remediation (80 of 117 [68%]). The CDs called for centralized remediation processes to improve resource allocation and better tools, including sharing information about learners’ past performance, to improve early identification and support for struggling students.
CONCLUSIONS: The prevailing clerkship remediation model is conducted episodically and in silos, which has contributed to persistent challenges, including delayed identification of struggling learners, limited sharing of learners’ educational needs across clerkships, and inadequate resources for CDs. A programmatic and collaborative remediation model should be embedded centrally in the school’s overall educational program and conducted longitudinally to support all students’ continuous growth.
PMID:41812056 | DOI:10.1093/acamed/wvag058
