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The Evolution of Resident Remedial Teaching at One Institution

Guerrasio, Jeannette MD; Brooks, Elizabeth PhD; Rumack, Carol M. MD; Aagaard, Eva M. MD

doi: 10.1097/ACM.0000000000002894

Residency program directors and teaching faculty invest an enormous amount of time, energy, and resources in providing underperforming at-risk learners with remedial teaching. A remediation program was created and centralized at the University of Colorado School of Medicine in 2006 and 2012, respectively, that consolidated expertise in and resources for learner assessment and individualized teaching for struggling learners, particularly those placed on probation or receiving letters of warning (called focused review letters) from their residency programs. Since the implementation of the program, the authors have observed a decrease in the number of residents being placed on probation, and, of those on probation, more are graduating and obtaining board certification. In this Article, the authors aim to describe the development and outcomes of the program and to explore possible reasons for the improved outcomes.

J. Guerrasio was professor, Division of Hospital Medicine, Department of Medicine, and director for remediation, University of Colorado School of Medicine, Aurora, Colorado, at the time of writing. She is currently in private practice at David L. Mellman, MD, PLLC, and working as a consultant, Denver, Colorado.

E. Brooks is assistant professor, Department of Community and Behavioral Health, University of Colorado School of Public Health, Aurora, Colorado.

C.M. Rumack is professor, Department of Radiology, and associate dean for graduate medical education, University of Colorado School of Medicine, Aurora, Colorado.

E.M. Aagaard is professor, Division of Medical Education, Department of Medicine, and senior associate dean for education, Washington University School of Medicine in St. Louis, St. Louis, Missouri.

Funding/Support: The University of Colorado’s President’s Teaching Scholars Program provided funding to hire a statistician and to access the Federation of State Medical Boards’ Physician Data Center.

Other disclosures: None reported.

Ethical approval: This was deemed a program evaluation and thus exempt by the Colorado Multiple Institutional Review Board.

Correspondence should be addressed to Jeannette Guerrasio, 4700 E Hale Pkwy., Suite 300/330, Denver, CO 80220; telephone: (303) 325-6515; email:

Copyright © 2019 by the Association of American Medical Colleges