Remediation: The Road Less Traveled 

By: Yakun Fu, Student Pharmacist, Ching-Ping Liu Student Pharmacist, Chuman Xie, Student Pharmacist, and Qitong Yang, Students Pharmacist

Doctor of Pharmacy (PharmD) programs are significantly challenging and may require numerous resources to promote student success.1 It is estimated between 6-15% of health professions students experience academic difficulties.2 When faced with academic failures, students may be required to repeat entire courses which could delay academic progression and increase financial burden. For students who fail to meet minimum competency, remediation provides various pathways to improve their knowledge and skills and proceed with professional development. Designing remediation policies can be challenging, and the rigid curriculum design of some PharmD programs may make implementation difficult. Additionally, remediation often requires many resources and may impact faculty workloads, students’ schedules, and budgets in cases where extra course supplies are needed.2

Investigation of Pharmacy Program Remediation Initiatives

We reviewed the 13 top-ranked U.S. pharmacy programs’ websites and student handbooks to identify their remediation policies. Assistant and associate deans for student and/or academic affairs were contacted for more detailed information when needed. We asked these individuals to describe their school’s definition of remediation, assessment of student eligibility for remediation, remediation strategies and procedures, preventative strategies, and remediation efficacy data. Various strategies were identified and described (Table 1).

Table 1. Prevention, Remediation, and Reassessment Strategies

Strategy (Percent) Description 
Prevention
Early warning systems (54%)Checkpoints throughout the duration of a course to identify students requiring assistance

Three major types of failure prevention strategies were identified, including provision of advising and resources regarding learning strategies to students who are at risk for failure (38%), monitoring and assessing student performance (31%), and providing sufficient practice opportunities (23%)

Early intervention methods include additional practice, tutoring, or counseling with course instructors to improve studying and test-taking skills
Remediation 
Summer restudy (15%)An abbreviated course retake or review which may include assessments for students to achieve a passing status 
Student-directed remediation (8%)Students assemble remediation plans in collaboration with instructors, based on available schedules and preferred learning strategies
Reassessment 
Written (46%)Written assignments or exams that represent class objectives; may include a variety of components and/or question formats 
Oral (15%)Oral exams that represent class objectives; may include topics such as physiology, drug mechanism or patient cases, depending on the course being remediated.
Case-based reassessments (15%)Case-based assessments with formats that may include multiple choice, short answer, written, and oral questions

Calls to Action

Based on our findings and review of available remediation literature, we suggest the following: 

  • Pharmacy programs could collaborate to determine best practices for developing remediation plans, including examples of individualized remediation strategies based on students’ needs regarding timing, methods, and areas of focus. Assembly of a guide may involve surveying students and faculty to determine ideal components of remediation plans, determining ways to optimize resource allocation, and establishing methods to measure efficacy of various remediation methods. 
  • Efficacy data for identified remediation strategies was not specified for any of the 13 schools, and none provided data measuring progression and success rates of students who received interventions. In addition, many schools stated they are still in the early stages of modeling and testing their remediation strategies and thus do not have enough data to measure efficacy at this time. Follow-up should be conducted with these programs. Efficacy analysis could help pharmacy programs to improve and guide the development of remediation policies. We believe that the effectiveness of remediation should be assessed by tracking students’ NAPLEX/PCOA scores, GPA, or course passing rate.3 

Moving Forward

We believe sustainable remediation strategies are necessary in pharmacy programs and may provide opportunities for pharmacy students to discover multiple roads to success. How has your institution implemented and assessed remediation policies? What remediation strategies would you recommend?

Acknowledgements: Dr. Jenny Van Amburgh and Dr. Michael Gonyeau of Bouvé School of Pharmacy  and Pharmaceutical Sciences 

References 

1. Maize DF, Fuller SH, Hritcko PM, et al. A review of remediation programs in pharmacy and  other health professions. Am J Pharm Educ. 2010;74(2):25. doi:10.5688/aj740225 

2. Chen JS, Matthews DE, Van Hooser J, et al. Improving the Remediation Process for Skills-based Laboratory Courses in the Doctor of Pharmacy Curriculum. Am J Pharm Educ. 2021;85(7):8447. doi:10.5688/ajpe8447

3. Palmer EC, Esposito ER, Shin M, Raake SE, Malcom DR, Daugherty KK. Impact of intersession course remediation on NAPLEX/PCOA scores in an accelerated doctor of pharmacy program. American Journal of Pharmaceutical Education. 2020;84(9). doi:10.5688/ajpe7827


Author Bio(s):  

Yakun Fu is a P3 pharmacy student at Northeastern University. Educational scholarship interests include  academia and ambulatory care. In her free time, enjoys painting. 

Ching-Ping Liu is a P3 pharmacy student at Northeastern University. Educational scholarship interests  include pediatrics and academia. In her free time, Ching-Ping enjoys photography, going to coffee shops,  playing the violin and piano. 

Chuman Xie is a P3 pharmacy student at Northeastern University. Educational scholarship interests  include academia and oncology. In her free time, Chuman enjoys photography, driving around Boston,  and hanging out with friends. 

Qitong Yang is a P3 pharmacy student at Northeastern University. Educational interests include  transitions of care, academia, and ambulatory care. Her interests include visiting art museums, fashion  illustration, writing, and playing with her cat.  


Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning

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