NLU PA Program — Didactic Year Handbook
development activity; study plan development; repeat or supplemental assessment; additional examination; repeat practical examination; repeat OSCE; additional faculty observation; other.
Remediation Start Date / Required Completion Date / Reassessment Date: _______________________________________________________
Responsible Faculty Member(s) / Additional Personnel Involved: _______________________________________________________
Section IV. Student Remediation Agreement
The student acknowledges receipt of the remediation plan and understands the identified performance deficiency, required remediation activities, expected outcomes, and reassessment process. The student’s signature acknowledges receipt and understanding of the remediation plan; it does not necessarily indicate agreement with the finding or decision.
Student Name / Signature / Date: _______________________________________________________
Section V. Faculty Remediation Authorization
The signing faculty member(s) confirm that the performance concern has been documented; the remediation requirement is based on established Program requirements, assessment data, and/or professional expectations; the plan identifies measurable goals and expected outcomes; the student has been informed of the requirements; documentation will be maintained in the student’s confidential educational record; and progress and outcome will be evaluated per established Program procedures.
Responsible Faculty Member Name / Title / Signature / Date: _______________________________________________________
Additional Faculty/Program Personnel Name/Title / Signature / Date, if applicable: _______________________________________________________
Section VI. Remediation Activity Tracking Log
Remediation Activity Completed
Faculty/Staff Responsible
Student Participation/Performance
Evidence Attached
Date
Section VII. Reassessment and Outcome
Reassessment method (check one): written examination; practical examination; OSCE; clinical skills assessment; faculty observation; standardized assessment; preceptor evaluation; SCPE evaluation; competency assessment; professionalism evaluation; portfolio review; other.
Page 27 of 93
Powered by FlippingBook