The process of remediating residents, who most commonly struggle in the areas of professionalism, medical knowledge, and patient care, is daunting.1,2 There is limited consensus on best practices for identifying the problem, developing an individualized remediation plan, and monitoring the learner for success, making the process both difficult and time-consuming. Resident remediation is made more complex by their position as both a learner and an employee. While faculty are likely to frame the resident’s struggles within the learning domain, requiring individualized teaching and mentoring, external stakeholders, such as a department of human resources, view residents as employees with both specific responsibilities and entitlements. The tension between these points of view can be especially difficult to resolve in the context of an ongoing or imminent remediation, leading to conflicting views regarding next steps and best practices.
We present the process mapping we utilized as a framework to engage with our institution's external stakeholders to incorporate their perspectives into a shared vision for early intervention and remediation of residents. Participants are invited to use this framework to stimulate further discussion of strategies for early identification of struggling learners, consideration of the role of informal remediation and development of guidelines for unsuccessful remediation in the context of their own institution’s administrative and employment structure.