Interventions for undergraduate and postgraduate medical learners with academic difficulties: A BEME systematic review update: BEME Guide No. 85

Clinical teachers often struggle to record trainee underperformance due to lacking evidence-based remediation options.
To provide updated evidence-based recommendations for addressing academic difficulties among undergraduate and postgraduate medical learners.
A systematic review searched databases including MEDLINE, CINAHL, EMBASE, ERIC, Education Source, and PsycINFO (2016–2021), replicating the original Best Evidence Medical Education 56 review strategy. Original research/innovation reports describing intervention(s) for medical learners with academic difficulties were included. Data extraction used Michie’s Behaviour Change Techniques (BCT) Taxonomy and program evaluation models from Stufflebeam and Kirkpatrick. Quality appraised used the Mixed Methods Appraisal Tool (MMAT). Authors synthesized extracted evidence by adapting GRADE approach to formulate recommendations.
Eighteen articles met the inclusion criteria, primarily addressing knowledge (66.7%), skills (66.7%), attitudinal problems (50%) and learner’s personal challenges (27.8%). Feedback and monitoring was the most frequently employed BCT. Study quality varied (MMAT 0–100%). We identified nineteen interventions (UG: n = 9, PG: n = 12), introducing twelve new thematic content. Newly thematic content addressed contemporary learning challenges such as academic procrastination, and use of technology-enhanced learning resources. Combined with previous interventions, the review offers a total dataset of 121 interventions.
This review offers additional evidence-based interventions for learners with academic difficulties, supporting teaching, learning, faculty development, and research efforts.

临床教师常因缺乏循证补救方案，难以记录受训者的表现不佳情况。本研究旨在为应对本科及研究生医学学习者的学业困境提供更新后的循证建议。本系统综述检索了MEDLINE、CINAHL、EMBASE、ERIC、Education Source及PsycINFO数据库（2016–2021年），复刻了原版《Best Evidence Medical Education 56》综述的检索策略。纳入了描述针对学业困境医学学习者干预措施的原创研究/创新报告。数据提取采用了Michie的行为改变技术（Behaviour Change Techniques, BCT）分类法，以及Stufflebeam和Kirkpatrick的项目评估模型。研究质量评价采用混合方法评价工具（Mixed Methods Appraisal Tool, MMAT）。作者通过调整GRADE分级方法对提取的证据进行整合，以形成相关建议。共有18篇文献符合纳入标准，其干预主要针对知识问题（66.7%）、技能问题（66.7%）、态度问题（50%）以及学习者个人挑战（27.8%）。反馈与监测是最常被使用的行为改变技术。研究质量存在差异（MMAT评分0~100%）。本综述共纳入19项干预措施（本科学习者：n=9，研究生学习者：n=12），新增12个主题干预类别。新增主题内容针对当代学习挑战，如学业拖延、技术增强型学习资源的应用等。结合既往已收录的干预措施，本综述最终形成包含121项干预措施的完整数据集。本综述为学业困境医学学习者提供了更多循证干预方案，可为教学实践、学习支持、师资发展及相关研究工作提供有力支撑。