Background
Remediation of struggling learners in pulmonary and critical care fellowship
programs is a challenge, even for experienced medical educators.
Objective
This evidence-based narrative review provides a framework program leaders may
use to address fellows having difficulty achieving competency during
fellowship training.
Methods
The relevant evidence for approaches on the basis of each learner’s
needs is reviewed and interpreted in the context of fellowship training in
pulmonary medicine and critical care. Issues addressed include bias in
fellow assessments and remediation, the impacts of the severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the specific
challenges of pulmonary and critical care fellowship programs, a brief
review of relevant legal issues, guidance on building and leveraging program
resources, and a discussion of learner outcomes.
Results
This results in a concise, evidence-based toolkit for program leaders based
around four pillars: early identification, fellow assessment, collaborative
intervention, and reassessment. Important concepts also include the need for
documentation, clear and written communication, and fellow-directed
approaches to the creation of achievable goals.
Conclusion
Evidence-based remediation helps struggling learners in pulmonary and
critical care fellowship to improve their ability to meet Accreditation
Council for Graduate Medical Education (ACGME) milestones.