Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island.
University of Michigan, Department of Internal Medicine, Ann Arbor, Michigan.
West J Emerg Med. 2017 Jan;18(1):110-113. doi: 10.5811/westjem.2016.10.31483. Epub 2016 Nov 21.
It is important that residency programs identify trainees who progress appropriately, as well as identify residents who fail to achieve educational milestones as expected so they may be remediated. The process of remediation varies greatly across training programs, due in part to the lack of standardized definitions for . The purpose of this educational advancement is to propose a clear remediation framework including definitions, management processes, documentation expectations and appropriate notifications. is initiated when a resident's performance is deficient in one or more of the outcomes-based milestones established by the Accreditation Council for Graduate Medical Education, but not significant enough to trigger formal remediation. occurs when deficiencies are significant enough to warrant formal documentation because informal remediation failed or because issues are substantial. The process includes documentation in the resident's file and notification of the graduate medical education office; however, the documentation is not disclosed if the resident successfully remediates. is initiated when a resident is unsuccessful in meeting the terms of formal remediation or if initial problems are significant enough to warrant immediate probation. The process is similar to formal remediation but also includes documentation extending to the final verification of training and employment letters. involves other stakeholders and occurs when a resident is unsuccessful in meeting the terms of probation or if initial problems are significant enough to warrant immediate termination.
住院医师培训计划应当识别出那些能够适当进步的学员，以及那些未能达到预期教育里程碑的学员，以便对他们进行补救。由于缺乏标准化的定义，补救的过程在各个培训计划中差异很大。本教育进阶旨在提出一个明确的补救框架，包括定义、管理流程、文件记录期望和适当的通知。当学员在研究生医学教育认证委员会设定的基于成果的里程碑中的一个或多个方面表现不足，但不足以触发正式补救程序时，就会启动。当缺陷足够严重，需要正式记录时，就会发生补救。这是因为非正式补救措施失败，或者问题很严重。补救过程包括在学员档案中记录文件，并通知研究生医学教育办公室；然而，如果学员成功补救，文件不会公开。当学员未能达到正式补救的要求，或者最初的问题足够严重，需要立即停职时，就会启动。这一过程类似于正式补救，但还包括扩展到最终培训和就业信件验证的文件记录。当学员未能满足停职的要求，或者最初的问题足够严重，需要立即终止时，就会涉及其他利益相关者。
