Prediction and prevention of failure: An early intervention to assist at-risk medical students

Abstract

Close similarity between predictor task and target task is important for accurate prediction of failure. Consideration should be given to dose effect and class size in the prevention of failure of at-risk students, and we recommend a systemic approach to intervention/remediation programmes, involving a whole semester of mandatory, weekly small group meetings with experienced teachers.

The validity of student tutors’ judgments in early detection of struggling in medical school. A prospective cohort study

“…A recent study reported on the administration of an exam already in week 2 of the program in order to identify at-risk students in a US-Caribbean medical school (Winston et al 2014). Of the students who failed this early exam, 65 % went on to fail one of the first three semesters in the program, corresponding to a positive predictive validity of 0.65.…”

“…In addition to the paucity of studies on how to best identify students at risk at the earliest possible time, the literature also reveals how challenging the task of preventing failure long term is (Tekian and Hruska 2004;Devoe et al 2007;Stegers-Jager et al 2013), and currently there seems to be little evidence to support 'best practice' in remediation (Hauer et al 2009;Cleland et al 2013;Winston et al 2014). On the optimistic side, active learning curricula have been found to improve program completion rates and times (Iputo and Kwizera 2005;Schmidt et al 2009), and it seems that prevention and remediation strategies which encourage student participation and ownership are worth examining further (Cleland et al 2005, Stegers-Jager et al 2013Winston et al 2014;Bierer et al 2015;Patel et al 2015;Gonsalvez et al 2015).…”

“…On the optimistic side, active learning curricula have been found to improve program completion rates and times (Iputo and Kwizera 2005;Schmidt et al 2009), and it seems that prevention and remediation strategies which encourage student participation and ownership are worth examining further (Cleland et al 2005, Stegers-Jager et al 2013Winston et al 2014;Bierer et al 2015;Patel et al 2015;Gonsalvez et al 2015). The results presented in this study add evidence to the growing literature on struggling medical students, indicating that teachers should probably worry less about inducing failure by acting on their perceptions of struggling or 'opening a can of worms', as they are more often than not justly alarmed about perceived strugglers-even when their perceptions are only based on informal judgments of in-class activities in large group settings and early in a course.…”

“…While these reservations might look like excuses or seem irresponsible to some, they also represent valid and important doubts on behalf of teachers. Even so, over the years many researchers have stressed the critical importance of early identification and early support of strugglers (Yao and Wright 2001;Evans et al 2010;Yates and James 2010;Steinert 2013;Winston et al 2014). Early identification and support has been presented as 'an important investment in the development and training of future health professionals' (Steinert 2013), and as the 'gold standard for educational supervision' (Evans et al 2010).…”

“…(Yates and James 2006;Tabby et al 2011;Steinert 2013;Winston et al 2014). In this paper we will use the term ''struggler'' to mean a student who progresses with difficulty, which may or may not involve a strenuous effort.…”