Remediation and rehabilitation programmes for health professionals: challenges for the future

Goulet, François; Thiffault, Johanne; Ladouceur, Roger

doi:10.1136/bmjqs-2017-007187

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Finally these recommendations [ 2 , 3 , 162 – 165 ] are consistent with a number of recent commentaries [ 9 , 10 , 15 , 18 , 79 , 85 , 101 , 166 – 168 ] and guidelines on remediation [ 14 , 150 , 169 ].…”

Section: Discussionsupporting

confidence: 82%

Post graduate remediation programs in medicine: a scoping review

et al. 2022

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Background Recognizing that physicians may struggle to achieve knowledge, skills, attitudes and or conduct at one or more stages during their training has highlighted the importance of the ‘deliberate practice of improving performance through practising beyond one’s comfort level under guidance’. However, variations in physician, program, contextual and healthcare and educational systems complicate efforts to create a consistent approach to remediation. Balancing the inevitable disparities in approaches and settings with the need for continuity and effective oversight of the remediation process, as well as the context and population specific nature of remediation, this review will scrutinise the remediation of physicians in training to better guide the design, structuring and oversight of new remediation programs. Methods Krishna’s Systematic Evidence Based Approach is adopted to guide this Systematic Scoping Review (SSR in SEBA) to enhance the transparency and reproducibility of this review. A structured search for articles on remediation programs for licenced physicians who have completed their pre-registration postings and who are in training positions published between 1st January 1990 and 31st December 2021 in PubMed, Scopus, ERIC, Google Scholar, PsycINFO, ASSIA, HMIC, DARE and Web of Science databases was carried out. The included articles were concurrently thematically and content analysed using SEBA’s Split Approach. Similarities in the identified themes and categories were combined in the Jigsaw Perspective and compared with the tabulated summaries of included articles in the Funnelling Process to create the domains that will guide discussions. Results The research team retrieved 5512 abstracts, reviewed 304 full-text articles and included 101 articles. The domains identified were characteristics, indications, frameworks, domains, enablers and barriers and unique features of remediation in licenced physicians in training programs. Conclusion Building upon our findings and guided by Hauer et al. approach to remediation and Taylor and Hamdy’s Multi-theories Model, we proffer a theoretically grounded 7-stage evidence-based remediation framework to enhance understanding of remediation in licenced physicians in training programs. We believe this framework can guide program design and reframe remediation’s role as an integral part of training programs and a source of support and professional, academic, research, interprofessional and personal development.

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Section: Discussionsupporting

confidence: 82%

Post graduate remediation programs in medicine: a scoping review

et al. 2022

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“…In fact, university policies and appeals processes exist to protect students from such concerns and to hold academics accountable for their conduct. Although survey recommendations clearly articulated the need to separate disability and misconduct in registration processes, misconduct may be an expression of disability or disadvantage, and overseas studies on other professions have advocated the need to monitor the efficacy of both remediation and rehabilitation programmes 22 . Currently, there is no nation‐wide monitoring of disability or misconduct within the profession, and some respondents identified this as a benefit to be derived from improved registration processes.…”

Section: Discussionmentioning

confidence: 99%

Disclosure of disability or misconduct in veterinary graduate registration: balancing confidentiality, equity and stakeholder interests

Raidal

Neutze²,

Strous³

2021

Aust Veterinary J

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Background Veterinary registration processes, including disclosure of disability or misconduct, vary across jurisdictions in Australasia, and there is currently no clear mechanism for the communication of registration requirements to prospective or current students. Procedures for registration of graduating students are evolving but are not necessarily responsive to conflicting imperatives for confidentiality, protection of stakeholder interests and graduate support. Objective To obtain opinions from members of the veterinary profession in Australasia on issues relating to graduate registration, including communication between veterinary schools and registration bodies. Method This was an online survey. Results Responses were received from 245 members of the profession, including employers, educators, current students, recent graduates and board members. Respondents agreed on the importance of the survey topic to all stakeholder groups, and responses reflected the complex, contestable and nuanced nature of inherent concepts. Responses were strongly polarised between individuals with an appetite for reform, improved discourse around disability and remediation of unprofessional conduct and those with concerns and experiences suggesting boards and educators could not responsibly manage processes that included increased disclosure of disability or prior conduct. Conclusion Issues related to disability and misconduct should be addressed separately in any change to registration processes. A harmonisation of registration processes across jurisdictions is desirable, but the legal implications of any potential changes require careful consideration. There is a need for improved support of disability, remediation of misconduct and a desire to promote diversity within the profession. The survey evoked strong emotions, and future discussion requires sensitivity, empathy and insight.

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Remediating doctors’ performance to restore patient safety: a realist review protocol

et al. 2018

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IntroductionUnderperformance by doctors poses a risk to patient safety. Remediation is an intervention designed to remedy underperformance and return a doctor to safe practice. Remediation is widely used across healthcare systems globally, and has clear implications for both patient safety and doctor retention. Yet, there is a poor evidence base to inform remediation programmes. In particular, there is a lack of understanding as to why and how a remedial intervention may work to change a doctor’s practice. The aim of this research is to identify why, how, in what contexts, for whom and to what extent remediation programmes for practising doctors work to support patient safety.Methods and analysisRealist review is an approach to evidence synthesis that seeks to develop programme theories about how an intervention works to produce its effects. The initial search strategy will involve: database and grey literature searching, citation searching and contacting authors. The evidence search will be extended as the review progresses and becomes more focused on the development of specific aspects of the programme theory. The development of the programme theory will involve input from a stakeholder group consisting of professional experts in the remediation process and patient representatives. Evidence synthesis will use a realist logic of analysis to interrogate data in order to develop and refine the initial programme theory into a more definitive realist programme theory of how remediation works. The study will follow and be reported according to Realist And Meta-narrative Evidence Syntheses—Evolving Standards (RAMESES).Ethics and disseminationEthical approval is not required. Our dissemination strategy will include input from our stakeholder group. Customised outputs will be developed using the knowledge-to-action cycle framework, and will be targeted to: policy-makers; education providers and regulators, the National Health Service, doctors and academics.PROSPERO registration numberCRD42018088779.

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Remediation and rehabilitation programmes for health professionals: challenges for the future

Cited by 3 publications

References 20 publications

Post graduate remediation programs in medicine: a scoping review

Post graduate remediation programs in medicine: a scoping review

Disclosure of disability or misconduct in veterinary graduate registration: balancing confidentiality, equity and stakeholder interests

Remediating doctors’ performance to restore patient safety: a realist review protocol

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