Abstract
Background
Previous work has shown that a programme drawing on a blend of theories improves outcomes for students who fail and repeat their first semester at medical school. Remediation of struggling students is achieved through a cognitive apprenticeship within a small community of inquiry. This requires expert teachers who perform unique roles such as facilitator, mentor, disciplinarian, diagnostician, and role model. However, significant differences in student outcomes have been observed between experienced and novice teachers. This study explores the practice of teachers in this remediation course to exemplify effective remediation strategies and investigate teacher differences.
Methods
This practice-based research focuses on direct observation of classroom teaching, where remediation processes emerge. Nineteen hours of small group sessions were recorded and transcribed. Ethnography and sociocultural discourse analysis were used to analyze selected samples of talk-in-context, demonstrating effective remediation practices and identifying differences between experienced and novice teachers.
Results
Long-term student outcomes are strongly correlated with teacher experience (r = 0.81). Experienced teachers provided more challenging facilitation, encouraged collaborative group dynamics, diagnosed cognitive errors more effectively, and frequently used metacognitive time-outs. They also made explicit curriculum links, fostering deeper student engagement and understanding.
Conclusions
Effective remediation involves small groups using dialogue for collaborative knowledge construction and social regulation. This requires experienced teachers who focus on both content and process, challenging students' assumptions, encouraging logical consistency, and providing metacognitive guidance. Such strategies foster curiosity, attitudinal shifts, and the development of independent critical thinkers.
Key Questions
1. What is the importance of remediation for struggling medical students?
Remediation supports struggling medical students by fostering cognitive growth and encouraging independent critical thinking through expert-guided small group learning.
2. What roles do experienced teachers play in remediation?
Experienced teachers act as facilitators, nurturing mentors, disciplinarians, diagnosticians, and role models, using their expertise to challenge students and promote metacognition.
3. How do experienced teachers differ from novice teachers in remediation?
Experienced teachers encourage collaborative group dynamics, diagnose cognitive errors more effectively, provide metacognitive time-outs, and make explicit curriculum connections.
4. What are the key outcomes of effective remediation?
Effective remediation leads to attitudinal shifts, curiosity, collaborative knowledge construction, and the development of independent critical thinkers.
