title: What is the Prevalence and Success of Remediation of Emergency Medicine Residents?
abstract: BACKGROUND
  The primary objective of this study was to determine the prevalence of remediation, competency domains for remediation, the length, and success rates of remediation in emergency medicine (EM).
  
  
  METHODS
  We developed the survey in Surveymonkey™ with attention to content and response process validity. EM program directors responded how many residents had been placed on remediation in the last three years. Details regarding the remediation were collected including indication, length and success. We reported descriptive data and estimated a multinomial logistic regression model.
  
  
  RESULTS
  We obtained 126/158 responses (79.7%). Ninety percent of programs had at least one resident on remediation in the last three years. The prevalence of remediation was 4.4%. Indications for remediation ranged from difficulties with one core competency to all six competencies (mean 1.9). The most common were medical knowledge (MK) (63.1% of residents), patient care (46.6%) and professionalism (31.5%). Mean length of remediation was eight months (range 1-36 months). Successful remediation was 59.9% of remediated residents; 31.3% reported ongoing remediation. In 8.7%, remediation was deemed "unsuccessful." Training year at time of identification for remediation (post-graduate year [PGY] 1), longer time spent in remediation, and concerns with practice-based learning (PBLI) and professionalism were found to have statistically significant association with unsuccessful remediation.
  
  
  CONCLUSIONS
  Remediation in EM residencies is common, with the most common areas being MK and patient care. The majority of residents are successfully remediated. PGY level, length of time spent in remediation, and the remediation of the competencies of PBLI and professionalism were associated with unsuccessful remediation.
authors.affiliation: SUNY Downstate/Kings County Hospital, Department of Emergency Medicine, New York, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Silverberg
authors.affiliation: Staten Island University Hospital, Department of Emergency Medicine, Staten Island, New York.
authors.forename: Moshe
authors.initials: M
authors.lastname: Weizberg
authors.affiliation: Rutgers New Jersey Medical School, Department of Emergency Medicine, Newark, New Jersey.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Murano
authors.affiliation: Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Smith
authors.affiliation: University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan.
authors.forename: John C
authors.initials: JC
authors.lastname: Burkhardt
authors.affiliation: University of Michigan Medical School, Department of Emergency Medicine, Ann Arbor, Michigan.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Santen
mesh_terms: D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000193:education* / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D016015:Logistic Models; D012073:Remedial Teaching / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States