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The following is a summary of “Remediation in Pediatric Residency Training: A National Survey of Pediatric Program Directors,” published in the January 2025 issue of Pediatrics by Nelsen et al.

Graduate medical education aims to equip residents with the necessary skills and knowledge to practice medicine independently. However, resident remediation is a common yet underexplored aspect of this training, with limited evidence to guide best practices. This study presents findings from a national survey conducted among pediatric residency programs to understand their experiences in identifying struggling residents, documenting remediation processes, and monitoring progress.

The survey achieved a 50.8% response rate, with 99 out of 195 programs participating. Results indicate that approximately 4.7% of residents required remediation, and an impressive 91% (262 out of 288) successfully completed the process. Programs primarily relied on data from the Clinical Competency Committee (CCC) (100%), rotation evaluations (98.9%), and direct observation (96.6%) to identify residents needing remediation. Most programs (88.8%) employed a structured improvement plan to document resident progress and assigned mentors or coaches to provide support.

Monitoring progress was a critical component, with nearly all programs (93.3%) using rotation evaluations to track residents’ advancements toward remediation goals. Despite these structured approaches, only two-thirds (66.3%) of program leaders felt their remediation processes were either very effective or effective, and slightly over half (56.2%) expressed satisfaction with their remediation practices.

The study also highlighted a positive correlation between the successful completion of remediation by residents and program leaders’ satisfaction with their remediation processes. Programs with higher success rates in remediation were more likely to report satisfaction with the effectiveness of their practices.

In conclusion, while remediation is a relatively frequent occurrence in pediatric residency, with a high success rate, there is significant room for improvement in the processes used. Enhancing these practices could lead to higher satisfaction among program leaders and ensure the successful graduation of competent pediatricians. This study underscores the need for ongoing refinement and standardization of remediation strategies to support struggling residents better and maintain high standards in pediatric medical education.

Source: sciencedirect.com/science/article/abs/pii/S1876285925000014