The word that makes students tremble: Remediation!

Remediation is not a punishment but a valuable learning tool

The process of remediation elicits a variety of responses from EMS educators. Some view remediation as a way to improve student learning and competency. Others see it as a "necessary evil" in EMS education. However, the reaction you receive from most students is one of disappointment, resistance, hesitation, and even anxiety.

According to the National Guidelines for Educating EMS Instructors (2002), remediation is a "deliberate educational activity designed to correct deficits identified during formal and informal evaluations". In the age of national accreditation, every program must have an effective evaluation system to identify knowledge deficits accurately and early.

A sound remediation process serves the instructor and student by identifying issues early, improving clinical skills, and maintaining competency. Remediation can provide an educator a systematic plan to assist students in developing learning strategies and skills for success.

It should also provides the program with an objective process to dismiss students who are unable to successfully remediate, refuse to improve their performance, or refuse to modify their behavior.

Students dislike remediation
Most students typically react to any kind of correction or objective criticism with resistance and resentment. Many students have conditioned themselves to focus on what is needed to pass the test instead of identifying gaps in their cognition, behavior, and performance. They have learned destructive attitudes about learning and view 'not knowing the answer' and receiving correction as a negative experience.

In fact, many students report that they initially feel like they are being punished even though they participate in a well defined and organized remediation. Most have never experienced a formal remediation process. After a couple of remediation experiences they realize its value to their learning.

Steps to successful remediation
Plan to succeed.

As someone once said, "plan your work and work your plan." Successful remediation starts with a systematic and well defined plan. A program policy should define your remediation process.

The process is embedded within the context of all program components (didactic, laboratory, and clinical), and it includes the use of a learning contract (stakeholder agreement) as an integral component of all stakeholders.

The program policy should address several questions for students. How will formal and informal evaluation methods be used to identify issues? What is the defined process of remediation? What are the student and instructor roles in remediation? How will remediation be evaluated or measured? What are the limits to remediation? Under what circumstances will disciplinary action accompany remediation?

Your policy should also address the role of evaluation, correction, and feedback in learning and have behavioral expectations that describe how students are expected to react when receiving correction, feedback, and disciplinary action.

2. Identify the problem.
The second step in the process is identifying the problem. An evaluation process should identify students who lack the skills or knowledge to successfully complete a program or who have an identified knowledge deficit in any of the three domains of learning (cognitive, psychomotor, and affective). Your program must have a regular evaluation process each semester and a terminal evaluation process at the end of the program.

The terminal evaluation usually includes a cut score to insure that students who graduate the program are safe and competent entry level providers. An effective terminal evaluation is comprehensive and must evaluate all three domains of learning.

Students must understand the role of a terminal evaluation process. Some students believe that any type of terminal evaluation is unfair. Since they have completed each semester, they think they should be allowed to complete the program. However, we have a moral, ethical, and legal obligation to insure that our graduates are safe and competent as they enter the profession.

3. Evaluate possible causes of the problem.
The cause of the problem may include deficits in critical thinking, accountability, responsibility, communication, teamwork, genuine regard, safety, and collaboration. A list of Core Performance Standards can be used to define measure competency in all three domains of learning.

4. Identify where the deficits came from: student, instructor, or educational process.
Sometimes the student and educator are equally at fault. Perhaps the issue came from the process. For instance, maybe the methods used for student and instructor communication could be improved.

5) Implement an action plan.
The action plan is the key to implementation of any successful remediation. It should be used in all components of the program. The action plan empowers the student and the instructor to once again work together as equal stakeholders of learning.

The action plan must specifically, but briefly describe how the student will remediate through planning, implementation, and evaluation of their progress.

Writing an action plan is not an easy task for any learner. A sample action plan might have the following components:

  • Identified area that requires remediation—Spell out the problem at hand.
  • Goal/Objective—Make it specific and realistic.
  • Motivation—What does the student need to change?
  • Action Steps – List the steps. "To achieve my goal, I will…….."
  • Timing—When will the student start each of the action steps and when will he/she evaluate his/her progress?
  • Obstacles—What problems will the student face? What will the student do to overcome these?
  • Responses—How will the student overcome the obstacles you have identified?
  • Resources—What are the student's resources? What additional resources will he/she need?
  • Evaluating progress—How will the student know when he/she have reached your goal?
  • Communication—How will the student report his/her progress? (e.g. turning in report, send an email, schedule a meeting, repeat skill, etc.)

Having a template can relly take the anxiety out of the process. I would be happy to share a sample action plan and template with you; just email me at

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