By Georgie Crewdson
Throughout this study, the authors explore salient factors contributing to the successful remediation of at-risk medical students: the role of the teacher. The study is predominantly qualitative with the inclusion of a small but impactful quantitative analysis of student pass rates after the remediation course. The aim is to identify the qualities that make a good teacher in the specific context of a medical student remediation program.
Before delving into the specific outcomes of this study, there is already an important observation that can be made, based solely on the premise of this study: UK universities do not have remediation programs in place for struggling undergraduate students. Although the implementation and effectiveness of these remediation programs could be the subject of a whole other case study, the authors of the current paper have shown implicitly that the remediation program has a positive influence on the student academic grades and experience. Therefore, the first actionable task to come (indirectly) from this study is to consider implementing remediation type programs for struggling undergraduate students. A full study of the effectiveness of these programs in the context of medical students is given by Winston et al. (2010a, b) . Although the implementation of such (mandatory) programs would be financially and logistically challenging for universities to implement on a large scale, implementation of similar types of programs at course level may not be so challenging. In order to extract actionable tasks from this study we can either assume that similar programs will be considered in the UK or (at university or department level) or simply identify the positive teaching qualities that can be translated to the current UK teaching methods (i.e., lectures and labs). Although the remediation process is a complicated and context dependent process, the author and previous research , highlights that the mandatory nature of these programs is an essential factor of their success and therefore the introduction of a in a voluntary or or peer run program may not have such a positive effect.
The qualitative analysis of the study is composed in one part of the students views of the teachers and in one part of the teachers views of their experiences. The authors report that in the positive feedback given by students (for all six teachers considered here), the words encouragement and motivation featured prominently, as did approachability and honesty. When the students were asked how the teachers helped their learning, the majority of the students responded with comments on the personal qualities of their teachers rather than the extent of their technical knowledge. Students valued being listened to and encouraged on a personal level. The caring nature of the teachers is also highly valued, where students reported appreciation for the teachers taking into account their individual needs. This reflects the findings of case study No.3, where an individualistic and student-centred approach to teaching is highly effective when it comes to student’s engagement and academic performance. Of the five core roles identified by the author (facilitator, nurturing mentor, disciplinarian, diagnostician, and roll model) the caring and personable qualities of the teachers are embodied through the nurturing mentor and diagnostician. Where, indeed, the teacher is required to diagnose the individual needs of the students and nurture these needs. As for the disciplinarian role, the study suggest that the teacher should act as a disruptive influence who prevents groupthink and premature convergence of opinions by promoting wider exploration -  this also goes hand in hand with the mandatory nature of the program.
From the teacher’s perspective, they highlight their intrinsic motivation to help students and have a genuine desire to see the student progress. This is key in the development of these programs and as we have seen from the students feedback a key factor in their success. The study reveals that the more experience the teacher has the better the performance of the students following the remediation program. Although the sample size is deemed to small by the authors and needs further investigation, they suggest that due to the exposure to different institutional setting and subject areas, the experienced teachers ar ewell -, valuing both cognitive and affective outcomes, whilst Inexperienced teachers may overvalue affective over cognitive student outcomes (Pajares 1992). From this we can suggest that if such programs were to be put into place, more experienced teachers should be the preferred facilitators over for example PhD students or newly qualified lecturers. It is indeed an attractive thought (from a university point of view) to hire lower paid facilitators for such programs as they would be considered ‘secondary’ to the curriculum. However, in the case of struggling students this would not be an optimal solution.
Upon reflection, let us identify possible actions that could be applied from these observations. There is an obvious link between academic results and the teacher-student relationship, this we have seen from this case study and case study No.3. How could this be applied to current UK teaching methods. Actionable suggestions include:
[Source Paper] Kalman A. Winston, Cees P.M. Van Der Vleuten & Albert J.J.A. Scherpbier (2012) The role of the teacher in remediating at-risk medical students, Medical Teacher, 34:11, e732-e742
 Winston KA, Van der Vleuten CPM, Scherpbier AJJA. 2010a. An investigation into the design and effectiveness of a mandatory cognitive skills programme for at-risk medical students. Med Teach 32(3):236–243.