Best Practices for Early Intervention and Remediation of Residents in Family Medicine: Insights From an Interdisciplinary Delphi Study

Abstract

Background: Remediation and early intervention for family medicine residents who experience performance problems represent a challenge for programs, faculty, and residents. Some evidence suggests that identifying those at risk for performance problems and providing support early may prevent more serious issues later in residency. Objectives: We wanted to explore the perspectives of content experts to identify best practices for early intervention and remediation to address common challenges and create a framework for more effective and inclusive early intervention and remediation. Methods: We used a Delphi approach to identify themes and best practices for early intervention and remediation, including qualitative interviews, identification of themes, clarification of essential practices, and confirmation of agreement with core medical faculty. Results: Our qualitative interviews and Delphi methodology identified best practices in five main categories: (a) early assessment and identification, (b) feedback, (c) resident engagement, (d) intervention strategies and resources, and (e) documentation. From an initial pool of 38 recommendations, we identified a final group of 11 practices that generated broad agreement among behavioral science faculty and core medical faculty. Conclusions: Key principles for early intervention and remediation include early skill assessment, data-driven feedback, collaborative processes, diverse resources, clear documentation, and faculty training for providing actionable feedback. While our Delphi study provided in-depth insights into various programs' practices, it may not capture unique practices across all programs. Future research on early intervention and remediation should explore current practices, aiming for specific, collaborative, and transparent processes, with insights from experienced faculty, to enhance equity and effectiveness.