NLU PA Program — Didactic Year Handbook
Section I. Student and Remediation Identification
Student Name / NLU ID / Cohort/Graduation Class: _______________________________________________________
Date Concern Identified / Date Remediation Initiated: _______________________________________________________
Course/Clinical Experience/Program Area: _______________________________________________________
Type of remediation (check all that apply): Didactic/Academic Performance; Knowledge Deficiency; Clinical Skills Performance; Clinical Reasoning; Professionalism; Communication; Documentation; SCPE/Clinical Performance; Summative Assessment; Program Competency; Program Learning Outcome; Examination Performance; Technical/Procedural Skill; Other.
Reason for Remediation: _______________________________________________________
Section II. Identification of Performance Deficiency
Applicable Requirement/Standard: _______________________________________________________
Expected Performance: _______________________________________________________
Student's Actual Performance: _______________________________________________________
Assessment or evidence demonstrating deficiency (check all that apply): Examination Score; Practical Examination; OSCE; Clinical Skills Assessment; Faculty Evaluation; Preceptor Evaluation; SCPE Evaluation; Professionalism Evaluation; Competency Assessment; Programmatic Assessment; Attendance/Participation Documentation; Other.
Assessment Date(s) / Score or Performance Result: _______________________________________________________
Description of Deficiency: _______________________________________________________
Section III. Remediation Plan
The remediation plan must be individualized to address the identified performance deficiency and must include measurable expectations and a method for determining the outcome of remediation.
Remediation Goal(s): _______________________________________________________
Required remediation activities (check all that apply): faculty-directed review; individual faculty meeting; small-group instruction; individualized tutoring; independent study; assigned readings; directed learning modules; skills practice; simulation; standardized patient encounter; clinical skills laboratory; additional patient encounter/clinical experience; documentation review; reflective assignment; professional
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