European Journal of Cardiovascular Medicine

The   academic   performance   of   undergraduate medical students may be subjective to numerous stressors such as academic burden, parental and peer pressure, psychological ailments like depression, burn out,stress, sleep disorders [1].

Furthermore, difficulty in understanding medium   of   instruction, perceived   parental   and   peer pressure and dissatisfaction with career choice have also been significantly linked with poor performance [2,3].

Remedial education is a multifaceted approach, tailoring remedial intervention plans to a student's specific needs. Remedial therapy focuses on skills rather than on content. In simple terms, a remedial measure is done to improve or correct performance and to assist students in order to achieve expected competencies [1,4].  It is offered to students who need (pedagogical/didactic) assistance.  Remedial teaching is designed to cater to the needs of children unable to keep pace with the teaching-learning process in a normal classroom. It is one of the acceptable solutions for low achievement [5]. The reasons identified for low academic achievement were non-curricular and the implemented remedial program proved to be effective [6].

Remediation can be defined as additional teaching above and beyond the standard curriculum, individualized to the learner who without the additional teaching would not achieve the necessary skills for the profession. Significant learning difficulties requiring remediation in the form of an individualized learning plan have been observed to  be experienced by 7-28% of medical trainees [7,8].

Four steps to effectively approach learning difficulties have been described in the SOAP model. These steps are detecting problems based on a subjective impression; gathering and documenting objective data, according to diagnostic hypotheses; making a pedagogical diagnosis based   on   this   assessment   and   planning   a   targeted remediation [9,10]. The subjective impressions are formed either by direct observation of the learner in action or on formal or informal interactions with the student.  But making  a pedagogical diagnosis in medical education consists of not only   identifying   discrepancy   between   the   expected performance standard and the demonstrated performance, and trying to establish the reason for underperformance, but    also    targeted    and    individualized    remediation measures [11].

The extra-curricular problems outweigh curricular problems. Proper guidance would help them overcome their problems and bring them back into the main stream as far as possible. Hence remedial teaching give as in-class assignments in must-know areas of selected topics in Anatomy [12].

The new CBME curriculum envisages taking remedial measures after a student has completed training but has not become eligible for appearing in university examination. No standardized and universally accepted remediation processes have yet been developed. There is a strong need for further research with regard to remediation that is evidence-based, individualized, and targeted according to pedagogical diagnosis.

Therefore, the present study was undertaken to identify the reasons for low achievement of the students in Anatomy and assess the effectiveness of remedial teaching.

AIM OF STUDY

Evidences exist that there is increase in number of underperformers in medical graduates. Both academic and non -academic problems contribute to learning difficulties. Early remedial measure is done to improve or correct performance and to assist students in order to achieve expected competencies. This necessitates early identification and introduction of individualized remedial measures to be undertaken for patient safety and quality care. Thus,the aim of present study is to study the effect of early remedial intervention on academic performance low achievers in Anatomy.

The study was conducted in the Department of Anatomy, Autonomous State Medical college, Fatehpur, Uttar Pradesh, India for a period of six months i.e, June 2021 to December 2021. First year medical students (2021-22), who failed in first terminal exam i.e. scoring less than 50% mark,both in theory and practical were selected as subjects after taking informed consent.  Dennis Congo Self-Assessment Study Skill Inventory was applied to all students of batch for obtaining information about study skills. On the basis of this , the low achievers will be  given

1. Academic support.
2. Study skill sessions.
3. Counselling regarding their various non- academic problems.

The result will be assessed by conducting a post- test and will be evaluated by applying Statistical Analysis.

In the present study  a total of 66 students participated in Study Skill questionnaire. Out of 66, 27 students were failed in anatomy first term exam. The median value observed in questionairre

Studying-34

Note taking-24

Memory score- 40

Test preperation -43

Concept-41

Time management—18

Remedial sessions were given in form of interactive sessions both in theory and practical classes.Potential remedial measures include written test(SAQs, MCQs), OSPE/OSCE stations, structured viva-voice(Khilnani, et al) After completion of each topic, a test module containing LAQ, SAQ, and MCQwere given to solve and discuss.A post-test was performed (from the topic asked in first sessional exam) after giving remedial measured shows significant improvement in their performance.

In the present study the main objective of remedial teaching is analysis of student’s performance and identifying the difficult topic areas.

Both in theory and practical training, remedial sessions were delivered as interactive sessions.Written tests (SAQs, MCQs), OSPE/OSCE stations, and organised viva-voice are examples of possible corrective actions (Khilnani, et al.). Each topic was followed by a test module with LAQ, SAQ, and MCQs to complete and debate.Following remedial instruction, a post-test covering the material covered in the first sessional exam was administered, and the results indicate a notable improvement in performance.

Poor performance of student was found to be due to curricular causes which were different from the study by Ananthakrishnan N and Vinutha S, where non-curricular causes were identified as causes of poor performance [3,5].

In the current study it was observed that a post-test was performed (from the topic asked in first sessional exam) after giving remedial measured shows significant improvement in their performance. This study was in accordance to the study conducted by the other research investigator  Reneega Gangadhar et al., in 2019 where, there was statistically significant difference (p-value test and post-test for assignments. There was also significant difference between fourth sessional and send up marks after remedial teaching. Remedial teaching helps low achievers to score better. Implementing this program right from the beginning will help low achievers to improve their academic performance [13].

In the present study it was recorded that the maximum marks were observedcin the students who were taking notes with 33 in number were passing, concept with 31, followed by test preparation with 30, followed by studying with 29, memory score with 26, and least for time management with 19.

This study was in parallel to the other study  the maximum positive score (36.36%) and highest average score (4.27) was for statement 10 where 36% strongly agreed about their inability to take notes. This is attributed to fast changing of powerpoint slides by the faculty and lack of clarity in explanation of concepts. It is interesting to note that 55% agreed with statement 16 regarding inability to study on their own, 73% agreed with statements 17 and 18 that they required additional help and lacked confidence regarding the subject. A 64% agreed with statements 19 and 20 about their inability to understand what is read and felt frustrated for not able to study.

The lowest average score (1.64) was for statement 11 where 54.5% of the study group strongly disagreed indicating that environment was conducive to learning. A study by Almuammria M performed a study on the impact of the environment in enhancing the academic achievement of the students. He found that there are a range of factors affecting academic achievement such as: learner factors, family factors and institution factors [9].

Another study by Vinutha S also showed significantly improved post-test performance and statistically significant higher send up marks [7].

Remedial   interventions   must   undergo   continuous   and rigorous evaluation throughout the academic program. The interventions  should  be  facilitated  by  teachers  capable  of pedagogical  diagnosis  who  can  also  play  the  roleof  an encouraging  mentor.Thus remedial teaching helped low achievers to score better [14,15]. The remediation  measures  enabled  by simple tools like a study skills inventory can help identify and  correct  learning difficulties  of medical students  at  an early  stage [16].  Such  tailored  or  individualized  remediation measures can greatly enhance the academic performance of undergraduate   medical   students   and   help   them   make satisfactory progress on the course [17,18].

Remedial education works well to raise poor achievers' academic standing and get them back into the mainstream as soon as possible. Remedial programs can be suggested to other paraclinical and clinical individuals as well as to all batches if they are discovered to be helpful in a small number of them. The program should be continued and expanded to junior batches, and teachers' conceptual and practical knowledge of remedial teaching should be continuously enhanced, according to the results of data collecting and analysis.

Declarations:

Conflicts of interest: There is no any conflict of interest associated with this study

Consent to participate: We have consent to participate.

Consent for publication: We have consent for the publication of this paper.

Authors' contributions: All the authors equally contributed the work.

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