"A clean slate": Insights for improving remediation from the perspectives of underperforming surgical trainees

Background: Remediation frameworks have centered around perspectives of educators. The aim of this study is to explore the insights proposed by surgical trainees to improve remediation processes. Methods: This qualitative study used semi-structured interviews with 11 doctors who have experienced formal remediation as a surgical trainee. We used reflexive thematic analysis on transcribed interviews. Results: Trainees recommended creating environments that safeguarded their well-being. Examples include trainee-led peer support groups and external mentors. Feedback conversations and remediation plans were flagged as needing improvement. Opportunities for forward planning for successful remediation were suggested including learning plans, program evaluation and aligning training program structure with expectations. Conclusions: These findings about trainees'insights on improving remediation highlighted the need for further emotional support for trainees. Supervisors need further support with feedback conversations and remediation plans. Actively seeking out trainee perspectives and integrating their recommendations when designing remediation processes should improve outcomes.