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


OBJECTIVE
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.


CONCLUSIONS
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.
Ross University School of Medicine, PO Box 266, Roseau, Commonwealth of Dominica. kwinston@rossmed.edu.dm
Kalman A
KA
Winston
Cees P M
CP
Van Der Vleuten
Albert J J A
AJ
Scherpbier
D000339:Affect; D003071:Cognition; D005180:Faculty, Medical / Q000458:organization & administration*; D006801:Humans; D024382:Professional Role; D012307:Risk Factors; D013337:Students, Medical; D013663:Teaching / Q000379:methods*