Rethinking Remediation: A Model to Support the Detailed Diagnosis of Clinicians' Performance Problems and the Development of Effective Remediation Plans

Linda Prescott-Clements*, Vicky Voller, Mark Bell, Natasha Nestors, Cees P. M. van der Vleuten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

15 Citations (Web of Science)
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Abstract

The successful remediation of clinicians demonstrating poor performance in the workplace is essential to ensure the provision of safe patient care. Clinicians may develop performance problems for numerous reasons, including health, personal factors, the workplace environment, or outdated knowledge/skills. Performance problems are often complex involving multifactorial issues, encompassing knowledge, skills, and professional behaviors. It is important that (where possible and appropriate) clinicians are supported through effective remediation to return them to safe clinical practice. A review of the literature demonstrated that research into remediation is in its infancy, with little known about the effectiveness of remediation programs currently. Current strategies for the development of remediation programs are mostly "intuitive"; a few draw upon established theories to inform their approach. Similarly, although it has been established that identification of the nature/scope of performance problems through assessment is an essential first step within remediation, the need for a more widespread "diagnosis" of why the problems exist is emerging. These reasons for poor performance, particularly in the context of experienced practicing clinicians, are likely to have an impact on the potential success of remediation and should be considered within the "diagnosis." A new model for diagnosing the performance problems of the clinicians has been developed, using behavioral change theories to explore known barriers to successful remediation, such as insight, motivation, attitude, self-efficacy, and the working environment, in addition to addressing known deficits regarding knowledge and skills. This novel approach is described in this article. An initial feasibility study has demonstrated the acceptability and practical implementation of our model.

Original languageEnglish
Pages (from-to)245-254
Number of pages10
JournalJournal of Continuing Education in the Health Professions
Volume37
Issue number4
DOIs
Publication statusPublished - 2017

Keywords

  • remediation behavioral change
  • revalidation
  • competence
  • poor performance
  • insight
  • integrated behavioral model
  • performance
  • knowledge translation
  • maintenance of certification
  • physician assessment/remediation
  • problem/dyscompetent physicians
  • dissemination of innovations
  • theory of planned behavior
  • transtheoretical model
  • CONTINUING MEDICAL-EDUCATION
  • PHYSICIANS
  • WORKPLACE
  • PROFESSIONALISM
  • STUDENTS
  • PROGRAM
  • DESIGN
  • SKILLS

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