Remediation and the Difficult Learner


Key Points:

  • Remediate the skill, not the test
  • Help students recognize their weaknesses and strengths
  • Your attitude impacts the learner
  • Distinguish between students who cannot do and those that will not do
  • Engage multiple teaching methods
  • Break learning into small steps
  • Model practices you want students to follow
  • Identify students at risk for failure as early as possible and intervene
  • Integrate a counseling component
  • Consistently apply academic standards



  • Initiate remediation procedures for students who do not meet competency requirements


Recommended Resources: 

Brief Review


Robert Brooks on learning strategies and encouraging struggling students. 1 minute.

Tips for Reaching Adult Learners. American Society on Aging. 6 minutes.

Adult training techniques: How to deal with disruptive learners. 6 minutes.


Learners in Difficulty: Defining the Problem. Practical Doc.

Learners in Difficulty: Fixing the Problem. Practical Doc.

Winston KA, Van Der Vleuten CP, Scherpbier AJ. Remediation of at-risk medical students: theory in action. BMC Med Educ. 2013 Sep 27;13:132. doi: 10.1186/1472-6920-13-132. PubMed PMID: 24070196

Mak-van der Vossen M, Peerdeman S, van Mook W, Croiset G, Kusurkar R. Assessing professional behaviour: Overcoming teachers' reluctance to fail students. BMC Res Notes. 2014 Jun 17;7:368. doi: 10.1186/1756-0500-7-368. PubMed
PMID: 24938392.

Domen RE. Resident remediation, probation, and dismissal basic considerations for program directors. Am J Clin Pathol. 2014 Jun;141(6):784-90. doi: 10.1309/AJCPSNPAP5R5NHUS. PubMed PMID: 24838321.

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.
PubMed PMID: 19704207.

The Case of the Exasperated Educator by Drs. Lindsay Melvin & Teresa Chan. ALiEM MEdIC series case 1.10.


O'Sullivan P. EASE: Development Program for Residency Program Directors and Coordinators. MedEdPORTAL Publications; 2007. Resources include topics related to goals and objectives, recruitment and remediation of residents, evaluation of performance, teaching strategies, program evaluation, program accreditation, and educational scholarship.

St. Hilaire R, Winston K, Harris-Alleyne J, Callender D, Thomas V, Gnecco S, Hall M, Ogrinc G, Frankel R. Student at Risk PBL Case. MedEdPORTAL Publications; 2013. This resource is a progressive disclosure format, problem based learning (PBL) case designed to sensitize students on behaviors that can influence their academic performance and highlight resources that are available to help them achieve their academic goals.


In-Depth Review


Strategic Remediation - Learners in Difficulty. Inis Jane Bardella, M.D. Rosalind Franklin University of Medicine. 23 minutes (can skip first 3 min).

Strategic Remediation 2 S.O.A.P. Inis Jane Bardella, M.D. Rosalind Franklin University of Medicine. 34 minutes.

Strategic Remediation Application of S.O.A.P. Inis Jane Bardella, M.D. Rosalind Franklin University of Medicine. 7 minutes.


Chou, Calvin L., and Adina Kalet. 2014. Remediation in medical education: a mid-course correction.

Guerrasio, Jeannette. 2013. Remediation of the struggling medical learner. Irwin, Pa: Association for Hospital Medical Education.


Physician Assessment and Clinical Education (PACE) Program. UC San Diego. Provides remediation and assessment programs on a variety of topics and that can be customized.

Managing the Trainee in Difficulty. National Health Service. Supporting a trainee in difficulty can be extremely challenging, yet immensely rewarding. This module explores the types of difficulty trainees may experience and considers a range of potential intervention strategies that may be adopted by supervisors to ensure the continuation of a positive training experience for all trainees.

Other Resources

Pre-Health Competencies and MCAT Foundational Concepts. AAMC. The Pre-health Collection begins with a focus on the competencies that are found on the MCAT and will expand with the emergence of additional pre-health competencies.