摘要：This study investigated the effectiveness of an innovative remediation program, based on promoting self-efficacy, a construct of self-regulation theory, which was developed to provide sustainable improvements in academic and clinical performance of underperforming medical students. Eighteen medical (eight 4th and ten 5th year) students participated in the remediation program. Interventions were multi-faceted and composed of a wide range of group activities. The efficacy of the intervention was evaluated using mixed-method approach consisting of interviews, questionnaire and quantitative analysis of OSCE outcomes (pre and post intervention). The in-depth interviews were used to explore the short- and long-term causal effects of the remediation program on improved performance. Students demonstrated significant improvements across 3 of the 5 domains measured in OSCE performance (management, diagnosis and communication). There was a 44% improvement in number of stations passed by participants post-remediation (95% CI = -52.25 to -35.64; r = 0.82). Large effect sizes were obtained, indicating the substantive significance of the results. Self-efficacy beliefs were markedly increased post-intervention with the total score increasing from 33.52 (SD=4.9) points pre-remediation to 45.71 (SD=5.1) points post-remediation (95% CI = -14.52 to -9.83; p<0.001; r = 0.77). Subsequent qualitative data suggested that beyond summative exam results, gains were translated to the clinical context with enhanced confidence and self–belief, enabling perceived improved performance in the workplace. Multi-dimensional, group orientated remediation, which emphasises self-efficacy beliefs, may enhance outcomes for students in both high stakes assessment and in the clinical context, thus allowing translational and longitudinal benefits.
