Myth Busters

Myths

  1. No help is available for residents unless they fail a rotation or are on Remediation

    Fact: We offer supports to help your resident succeed.

    • If you are worried about a resident in your program
    • If you have had colleagues approach you with concerns about a resident’s performance,
    • If a resident in your program has received borderline scores or concerning comments on evaluations
    • If a resident has self-identified as struggling and looking for supports,

  1. Supports exist for residents but not faculty around learning difficulties.

    Fact: We offer supports to help faculty help residents. Contact us for:

    • Individual consults
    • Faculty retreats
    • Faculty development workshops on feedback, documentation, etc.
    • Teaching resource
    • If a resident has self-identified as struggling and looking for supports,

  1. Professionalism can't be remediated.

    Fact: While it is difficult to observe and evaluate VALUES, it is possible to set expectations of and provide feedback on BEHAVIORS. Professional behaviors can be taught, coached, and remediated.

    Consider the following resource: Understanding Medical Professionalism | AccessMedicine | McGraw Hill Medical (mhmedical.com)

     

     

  1. Remediation is punishment.

    Fact: Remediation

    • Is an individualized educational support
    • Provides frequent and specific feedback and assessment for growth
    • Is designed to help a resident correct specific performance gaps

     

    Consider the following resource: https://link.springer.com/book/10.1007/978-1-4614-9025-8

     

  1. Perfection is expected in medical education.

    Fact: Professional development is a trajectory where it is expected that learners start as novices and progress over their careers into experts. Growth mindset, the belief that a person’s abilities will improve over time, is the foundation for medical education and continued professional development. 

    Growth Mindset in The University of Cincinnati Internal Medicine Residency - YouTube

  1. Residents can appeal all forms of constructive feedback.

    Fact: An appeal is a formal request for a decision made about a resident’s progress through their program to be reviewed and changed. Not all decisions are appealable and those that are appealable are listed and governed by the PGME Appeals Policy. 

    A Resident may appeal: 
    • An end of Rotation ITER decision which is overall “unsatisfactory” or “fail”; 
    • A decision that Probation is required; 
    • A decision that a Resident has failed Remediation; 
    • A decision that a Resident has failed Probation; or 
    • A decision that a Resident is being dismissed. 
    A Resident may not appeal: 
    • A decision that Remediation is required; 
    • Any outcome of a Learning Support Plan; 
    • Assessments or decisions that are Formative in nature (i.e. single Entrustable Professional Activity (EPA)); 
    • A decision that their status is “Not Progressing as Expected”; 
    • Accommodation decisions made by the Accommodation Assessment Committee pursuant to the PGME Postgraduate Medical Learner Accommodation Process; or 
    • An end of Rotation ITER decision which is “marginal” or “satisfactory” but with specific performance deficiencies
     

  1. CBD means that time in residency is no longer a relevant factor in training.

    Fact: CBD is a competence-based program with time as one of the variables that helps achieve this competence. Competence is used as a surrogate marker of how much time the resident requires in training. Lack of progress (which is also one of the triggers of remediation) is the sign that the resident needs more time. Remediation IS the extra time that we provide when a resident is not progressing. Extension of training results from this extra time having been provided to the resident during the remediation. 

    Other factors to consider regarding extension of training due to Remediation include:
    • how much the rotations were adjusted
    • “graduated” responsibilities (seeing fewer/less complex patients for part of the remediation)