The role of the teacher in remediating at-risk medical students

Kalman A. Winston*, Cees P. M. Van Der Vleuten, Albert J. J. A. Scherpbier

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Previous work identified complex ingredients of a remediation programme for at-risk medical students: mandatory, stable, facilitated small groups promote both cognitive and affective developments, with improved self-regulation, metacognition and reflection resulting in significant performance gains. Aim: We explore the teachers' role in this intervention, aiming to expand and deepen understanding of remediation methods in medical education. Methods: Extensive qualitative data from student surveys and in-depth teacher interviews, along with quantitative student performance data, produced a rich description of remediation processes. Results: Remediation should support emotional needs and foster cognitive and metacognitive skills for self-regulation and critical thinking. Teachers of remediation need to motivate, critique, challenge and advise their learners, applying teaching and contextual expertise in a constructivist, student-centred environment that fosters curiosity and joy for learning. Teachers of remediation can mediate these processes through embodiment of five core roles: facilitator, nurturing mentor, disciplinarian, diagnostician and modeller of desired skills, attitudes and behaviours. Conclusion: Remediation of struggling medical students can be achieved through a cognitive apprenticeship within a small community of inquiry that motivates and challenges the students. This community needs teachers capable of performing a unique combination of roles that demands high levels of teaching presence and practical wisdom.
Original languageEnglish
Pages (from-to)E732-E742
JournalMedical Teacher
Issue number11
Publication statusPublished - 2012

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