The COVID-19 pandemic has resulted in a massive adaptation in health professions education, with a shift from inperson learning activities to a sudden heavy reliance on internet-mediated education. Some health professions schools will have already had considerable educational technology and cultural infrastructure in place, making such a shift more of a different emphasis in provision. For others, this shift will have been a considerable dislocation for both educators and learners in the provision of education. To aid educators make this shift effectively, this 12 Tips article presents a compendium of key principles and practical recommendations that apply to the modalities that make up online learning. The emphasis is on design features that can be rapidly implemented and optimised for the current pandemic. Where applicable, we have pointed out how these short-term shifts can also be beneficial for the long-term integration of educational technology into the organisations' infrastructure. The need for adaptability on the part of educators and learners is an important over-arching theme. By demonstrating these core values of the health professions school in a time of crisis, the manner in which the shift to online learning is carried out sends its own important message to novice health professionals who are in the process of developing their professional identities as learners and as clinicians.

Most remediation interventions in medical education focus on improving performance to pass a re-sit of an examination or assessment and provide no insight into what types of extra support work, or how much extra teaching is critical, in terms of developing learning. More recent studies are generally of better quality. Rigorous approaches to developing and evaluating remediation interventions are required.

ContextStudents who engage in reflective, self-regulated learning (SRL) are more likely to have academic success, whereas students who have deficits in SRL tend to struggle with academic performance. Understanding how SRL is used by struggling medical students will inform development of better remediation. MethodsSemi-structured interviews were conducted with 55 students who had failed the final re-sit assessment at two medical schools in the UK to explore their use of SRL. A thematic analysis approach (TA) was used to identify factors from the lived experience of students who failed at high stakes assessment that prevented them from appropriately overcoming failure. ResultsStruggling students had inappropriate learning strategies as well as inflated beliefs and expectations about their performance on the course. Their adjustment after a failed assessment was restricted by the coping strategies they used to deal with the failure experience, which included normalising the experience and externally attributing reasons for failing. These strategies were a barrier to taking up formal support and seeking informal help from peers. ConclusionsThis study identified that struggling students had problems with SRL, thereby entering a cycle of failure due to limited attempts to access formal and informal support. The findings have implications for how medical schools can provide remediation opportunities for struggling students. Implications for how medical schools can create a culture that supports uptake of SRL and help-seeking, and improve remediation for struggling students are discussed.

Background: Failing a high-stakes assessment at medical school is a major event for those who go through the experience. Students who fail at medical school may be more likely to struggle in professional practice, therefore helping individuals overcome problems and respond appropriately is important. There is little understanding about what factors influence how individuals experience failure or make sense of the failing experience in remediation. The aim of this study was to investigate the complexity surrounding the failure experience from the student's perspective using interpretative phenomenological analysis (IPA). Methods: The accounts of three medical students who had failed final re-sit exams, were subjected to in-depth analysis using IPA methodology. IPA was used to analyse each transcript case-by-case allowing the researcher to make sense of the participant's subjective world. The analysis process allowed the complexity surrounding the failure to be highlighted, alongside a narrative describing how students made sense of the experience.