Principles of Remediation for the Struggling Neurosurgery Resident

Abstract

When resident physicians fail to demonstrate appropriate milestone competencies early in their neurologic surgery residency, a plan of remediation is necessary. Once any psychologic, physical, or behavioral causes of identified knowledge or psychomotor deficiencies have been identified and addressed, the next step is to develop a plan to close these gaps. Specific areas that are assessed for deficits include medical knowledge, clinical reasoning and judgment, clinical skills, time management and organization, interpersonal skills, communication, and professionalism. Specific learning goals and objectives, as well as teaching and learning methods, pertain to the unique areas of deficit, and all of these must be considered with the goal of developing a resident-specific remediation plan. A plan for assessment of the remediation process is described, including an evaluation of what constitutes individual resident remediation success. Finally, a discussion of the prior resident remediation studies across many disciplines is made.