{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:49:26Z","timestamp":1777945766875,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Residents in difficulty represent a significant challenge in postgraduate medical education. Early, structured remediation may improve academic and clinical performance, yet regional evidence from family medicine training programs remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of a structured remediation program on examination performance and clinical assessments of family medicine residents in difficulty, and to explore resident-perceived mechanisms contributing to improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A mixed-methods study was conducted at a single accredited family medicine training center over three academic years (2022\u20132025). Quantitative analysis included a retrospective review of promotion examination scores and clinical assessment outcomes before and after participation in a standardized remediation program. Qualitative data were obtained through semi-structured interviews with participating residents and analyzed thematically. Wilcoxon signed-rank test, Stuart\u2013Maxwell test, and multivariable linear regression were used to assess performance changes and predictors of post-course outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-one first-year family medicine residents were included. Mean promotion examination scores improved significantly from 55.1 \u00b1 2.4 pre-course to 79.0 \u00b1 5.1 post-course (p &lt; 0.0001). Clinical assessment outcomes improved from universal borderline or failing status to 100% pass rates (p = 0.0009). Perceived exam difficulty decreased significantly following remediation (p &lt; 0.0001). Multivariable analysis showed that age, gender, and training sector were independently associated with post-course scores. Qualitative analysis identified five key themes underlying improvement: transformation of learning strategies, enhanced clinical exposure, mentorship support, feedback-driven reflection, and professional accountability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A structured remediation program was associated with significant improvements in academic performance, clinical competence, and learner confidence among family medicine residents in difficulty. Early, supportive, and mentorship-driven remediation may represent an important component of postgraduate family medicine training.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121261448293","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:46:58Z","timestamp":1777510018000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a structured remediation program on academic performance of family medicine residents in difficulty: A training centre experience"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7434-7432","authenticated-orcid":false,"given":"Malak A.","family":"Al Shammari","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_3_6_2_2","volume-title":"GP Specialty Training Curriculum & Assessment Framework","author":"Royal College of General Practitioners (RCGP)","unstructured":"Royal College of General Practitioners (RCGP). GP Specialty Training Curriculum & Assessment Framework."},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001888-199405000-00003"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/01421590701210907"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.3109\/0142159X.2010.507710"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.08.012"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38730.678310.63"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_917_23"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000122"},{"issue":"7","key":"e_1_3_6_10_2","first-page":"664","article-title":"Remediation strategies and students\u2019 clinical performance","volume":"26","author":"Faustinella F","year":"2004","unstructured":"Faustinella F, Orlando P, Colletti LHJ, et al. Remediation strategies and students\u2019 clinical performance. Med Teach 2004; 26(7): 664\u2013665.","journal-title":"Med Teach"},{"key":"e_1_3_6_11_2","volume-title":"Program requirements for graduate medical education in family medicine","author":"Accreditation Council for Graduate Medical Education (ACGME)","unstructured":"Accreditation Council for Graduate Medical Education (ACGME). Program requirements for graduate medical education in family medicine."},{"key":"e_1_3_6_12_2","volume-title":"Saudi Board Family Medicine Curriculum and Training Regulations","author":"Saudi Commission for Health Specialties (SCFHS)","unstructured":"Saudi Commission for Health Specialties (SCFHS). Saudi Board Family Medicine Curriculum and Training Regulations. Riyadh: Saudi Commission for Health Specialties."},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/medu.12052"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001855"},{"issue":"7","key":"e_1_3_6_15_2","first-page":"1013","article-title":"Is remediation in medical education effective? A systematic review","volume":"96","author":"Boileau E","year":"2021","unstructured":"Boileau E, St-Onge C, Aud\u00e9tat MC. Is remediation in medical education effective? A systematic review. Acad Med 2021; 96(7): 1013\u20131024. https:\/\/doi.org\/10.1097\/ACM.0000000000004043","journal-title":"Acad Med"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e3181bf3170"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/S40037-012-0012-5"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6920-11-101"},{"issue":"5","key":"e_1_3_6_19_2","first-page":"Doc70","article-title":"Can the \u2018assessment drives learning\u2019 effect be detected in clinical skills training? Implications for curriculum design and resource planning","volume":"29","author":"Buss B","year":"2012","unstructured":"Buss B, Krautter M, M\u00f6ltner A, et al. Can the \u2018assessment drives learning\u2019 effect be detected in clinical skills training? Implications for curriculum design and resource planning. 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