Moderated by Martha Garcia
Session Coordinator: Changiz Mohiyeddini

Presentation 1 - Remediation Redefined: A Systematic Review Investigating the Effectiveness of Faculty-Led Remediation Practices - A Mixed Method
Maria Patricia Ascano
Touro University Nevada

Purpose
Remediation is the process by which students who failed a course must perform successfully on a subject-specific examination, demonstrating a qualifying level of competency. Remediation methodologies differ among medical institutions. The prevalent approach is the self-study method, whereby a failing student is given a specific period to relearn the material before being re-examined to earn a passing grade. Another approach is where faculty provide a structured framework that may include small group active learning strategies, individualized feedback, and reflection. The study's goal was to find if faculty-led remediation is more effective than self-study for a medical student's success during the didactic years. 

Methods
A quantitative approach was utilized to evaluate the outcomes of different remediation strategies within the first and second didactic years of medical school education. Articles were hand searched using keywords in library databases such as PubMed, Dissertations and Theses Global (ProQuest), ERIC, PsycInfo (EBSCO), and Google Scholar. This study focused on two remediation strategies, namely, faculty-led remediation and independent self-study methods. The exclusion criteria for the study included remediation during clinical rotations, other graduate education remedial courses, and tutoring. 

Results
The preliminary results indicate that remediation methods where faculty intervention was present led to a greater number of passing students along with higher passing scores upon reassessment. It was further observed that students with a greater support system from faculty, as well as group-based activities, performed better than students who utilized an independent study approach. 

Conclusions
As the preliminary results indicated, faulty interventions lead to greater success than independent self-study focused remediation. By the end of this review, more detailed remediation practices will be outlined. The goal is to select the best remediation strategy that leads to better academic success in the didactic years of medical school.

AWARD NOMINEE
Presentation 2 - Examining the Prevalence and Use of Open-Ended Questions in the Assessment of Medical Knowledge in US Medical Students
Doreen M. Olvet
Donald and Barbara Zucker SOM at Hofstra/Northwell

Purpose
Recent publications describe the value and feasibility of open-ended questions (OEQs) to assess medical knowledge. Incorporation of OEQs into NBME exams additionally incentivizes schools to prepare their students for this assessment format. However, it is unknown how many US medical schools include OEQs in their assessment toolkit. The objective of this study is to determine the prevalence and describe the use of OEQs in medical student knowledge assessment in the US. 

Methods
An online survey was sent out to all 156 accredited US medical schools. Questions addressed the use of OEQs to assess medical knowledge in the pre-clerkship and clerkship years. Descriptive statistics were calculated. 

Results
Currently, 53 medical schools have completed the survey (34% response rate). Thirty-four schools (64%) reported using OEQs for medical knowledge assessment during the pre-clerkship. Twenty of the 34 (59%) use OEQs for formative and 28 (82%) for summative assessment. The type of format included short answer (85%), essay (62%) and fill in the blank/phrases (24%). A majority of schools (88%) reported that OEQs make up less than 50% of pre-clerkship assessment of medical knowledge and the remaining schools utilize OEQs for most or all of the assessment (70-100%). Only 11 schools (21%) use OEQs for medical knowledge assessment in the clerkships. 100% of the 11 schools using OEQs in clerkships for summative assessment and only 5 (45%) for formative assessment. Clerkship OEQs were either in essay (64%) or short answer format (64%). On average, schools have used OEQs for 9.5 years (range: 1-21 years). 

Conclusions
More than half of the respondents use OEQs, mostly in the pre-clerkship setting. Among these schools, OEQs make up less than half of the assessment of medical knowledge. The low survey response rate may result in an overestimation of OEQ use; however, data collection is ongoing. Data on why schools utilize OEQs is also being collected.
 

AWARD NOMINEE
Presentation 3 - Mixed Methods Needs Assessment Using Framework Analysis
Priyadarshini Dattathreya
Ross University School of Medicine

Purpose
Learning needs assessments are an integral part of continuous quality improvement. Our goal was to conduct a competency-based learning needs assessment of our matriculating medical students using the Association of American Medical Colleges (AAMC) competencies for entering medical students as the framework. This abstract describes how the use of framework analysis method met our goal. 

Methods
We used exploratory sequential mixed methods design to conduct the needs assessment. We surveyed faculty, tutors and first year medical students to collect qualitative data on learning needs for our matriculating medical students. We analyzed the data using the five-step process of framework analysis. The steps included familiarizing with the data, deductively categorizing data using AAMC competencies as the thematic framework, coding data snippets under each category, charting the codes on a framework matrix and interpreting the mapped data. We reviewed the mapped data independently and with experts to create a 29-item quantitative survey, each item outlining a specific need. We administered the survey to all pre-clinical students and asked them to rate their competence and importance score for each item using a 5-point Likert scale. We used the scores to calculate the Mean Weighted Discrepancy Score (MWDS) which indicated the size of learning gaps. 

Results
70 participants completed the qualitative survey. 248 pre-clinical students completed the quantitative survey (20.9% response rate). Cronbach’s alpha coefficient was 0.92. 19 out of the 29 items had a MWDS of >5.00.

Conclusions
The framework analysis was the ideal qualitative data analysis method for our needs assessment. It supported the exploration of learning needs from multiple perspectives and aligned them with the AAMC competencies. The output generated a quantitative survey which was critical to quantify learning gaps. Therefore, framework analysis supported a competency-based learning needs assessment of matriculating medical students and informed our continuous quality improvement processes.