☐ Individualized tutoring ☐ Independent study ☐ Assigned readings ☐ Directed learning modules ☐ Skills practice ☐ Simulation ☐ Standardized patient encounter ☐ Clinical skills laboratory ☐ Additional patient encounter/clinical experience, when appropriate ☐ Documentation review ☐ Reflective assignment ☐ Professional development activity ☐ Study plan development ☐ Repeat or supplemental assessment ☐ Additional examination ☐ Repeat practical examination ☐ Repeat OSCE ☐ Additional faculty observation ☐ Other: _________________________________________________
Detailed Description of Required Activities:
C. Remediation Timeline
Remediation Start Date: ____________________________________
Required Completion Date: __________________________________
Reassessment Date: ________________________________________
Responsible Faculty Member(s):
Additional Personnel Involved, if Applicable:
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