12 - A Metacognitive Approach to Remediation

Poster Board Number: 12
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Odd poster #s – first hour
Even poster #s – second hour

Abstract Body : Introduction: Remediation is a highly complex process involving learners, faculty, systems, and societal factors. Challenges in remediation include faculty availability and interest, and the individualized nature of students’ challenges. A reflection-based remediation format was implemented for first-year dental students to provide the opportunity to engage in reflection and to develop metacognitive skills. The overall goal of the activity was to help students understand their own mistakes, as well as develop a strategy for learning and studying for future exams. A secondary goal was to normalize the remediation process so that it was not viewed as punitive, but as an opportunity for learning. This poster outlines the development and process of this remediation format and provides preliminary findings related to student participation in the remediation process.
Methods: Reflection-based remediation was mandatory for students receiving less than 70% on a practical exam, but was presented as an optional opportunity to the rest of the class. This remediation process had two parts: part 1 was done at home where students reviewed their exam answer sheets and prepared a written explanation and analysis for each question missed. Students were instructed to provide a reasoning for their incorrect answers and justification for correct answers and to draw comparisons between the two. Students were permitted to use external resources and received up to 2 points for part 1. Part 2 was an in-class assessment in which students were asked to repeat this process on a subset of the missed questions, without the use of any notes or resources. Questions for part 2 were picked based on the relevance of the structure for dentistry. Students could receive up to 8 points for part 2. Anecdotal information from student participants as well as aggregate data from the remediation process across two years was considered and reviewed to identify benefits, challenges, and trends.
Results: Examination of two years of data revealed that on average 13% of students failed the anatomy examination on back muscles and upper limb. These students were required to participate in remediation. Because remediation was open to the entire class, 69% of students participated in remediation. After remediation, 43% of the participating students improved their exam scores on the next exam. Student comments to faculty suggest that the remediation process was effective in fostering an environment that encourages students to reflect on mistakes. Many students also revealed that they started using the remediation method as a study strategy. By reading the remediation reflections, instructors were able to provide feedback, identify gaps in student learning, and adjust teaching to address these gaps.
Conclusions: Remediation is intended to support all learners in achieving competence. It is possible to develop remediation policies and procedures that provide opportunities for reflection and the development of metacognitive skills, without placing too great a burden on faculty or students. Given the potential for remediation to help develop metacognitive skills, It is essential to normalize remediation in medical education. Additional research is necessary to determine the true impact of reflection-based remediation on grade improvement, changes in student study skills, and student perceptions of remediation.