When a learner is struggling in the clinical environment, the most obvious explanation can sometimes be the wrong one.
A student who has difficulty developing a differential diagnosis may not simply need to “study more.” A learner who stumbles during a difficult patient conversation may have adequate medical knowledge but lack a framework for putting that knowledge into practice. And a student whose oral presentations feel disorganized may be gathering the right information without yet knowing how to communicate the clinical reasoning behind it.
These are different problems. They require different solutions.
That distinction was at the center of Aquifer’s October 6 webinar, How to Help the Struggling Learner: From Early Signals to Targeted Support, which explored how educators can move from recognizing early signs of learner difficulty to identifying the specific support a learner needs.
The broader implication is an important shift in health professions education: struggling learners benefit not from more practice, but from the right practice.
When a learner falls short of expectations, there can be pressure to act quickly: assign more reading, repeat content, complete additional cases, or increase study time.
But remediation is most effective when it starts one step earlier.
Before prescribing more learning, educators need to identify what is actually getting in the learner’s way.
Is the learner having difficulty organizing knowledge into a prioritized differential? Translating knowledge into effective communication with patients and families? Distilling a clinical encounter into a concise presentation that makes their reasoning visible?
Those distinctions matter because performance challenges do not always point to a lack of knowledge. Sometimes the gap lies in how knowledge is organized, applied, communicated, or demonstrated.
The future of learner support should be less about assigning “more” and more about prescribing the right practice targeted for the specific performance gap.
This is where Aquifer can become particularly useful for educators working with learners who need additional support.
Aquifer’s cases and teaching resources can be used not simply as additional coursework, but as targeted practice matched to an identified learner need.
An educator who identifies a clinical reasoning gap can direct a learner toward experiences that make reasoning processes explicit and give the learner opportunities to construct and prioritize a differential. For example:
Use an Aquifer case with the Case Analysis Tool: Assign a case with a planned stopping point before the diagnosis is revealed. Ask learners to identify key clinical findings, construct a problem statement, and prioritize their differential diagnosis before comparing their reasoning with expert explanations.
Practice clinical reasoning with Virtual Patient Encounters (VPEs): Have learners conduct virtual patient interviews, ask questions that distinguish between possible diagnoses, and adjust their differential as new information emerges. Use individualized feedback to identify gaps and guide targeted practice.
When the challenge is communication, an educator can select case content or virtual patient encounters that provide opportunities to practice difficult conversations. And when a learner understands the medicine but struggles to make their thinking visible in an oral presentation, resources focused on problem representation, organization, and presentation skills can provide a structure for deliberate practice and feedback.
The important shift is in how the resources are used: start with the learner’s identified need, then choose the learning experience—not the other way around.
For specific Aquifer cases, tools, and activities matched to these common scenarios, see Helping the Struggling Learner: Learner Supports.
No single case, module, or intervention can “fix” a struggling learner. Nor should remediation be reduced to completing a checklist of additional assignments.
Instead, educators can use a more intentional cycle:
Identify the performance gap → select targeted practice → observe performance → provide feedback → reassess.
That approach makes learner support more individualized while also giving faculty a clearer framework for deciding what to do next.
It also reframes remediation itself. Rather than treating struggle as a signal that a learner simply needs more content, educators can treat it as information—evidence that helps them determine which underlying skill needs attention and what kind of practice will move the learner forward.
As the October 6 webinar, How to Help the Struggling Learner: From Early Signals to Targeted Support, emphasized, identifying that a learner is struggling is only the beginning. The more consequential question is what educators do next.
Health professions education increasingly asks learners to do much more than know the right answer. They must organize information, reason through uncertainty, communicate with patients and colleagues, and make their thinking visible.
Supporting learners effectively requires the same level of precision.
We should not ask struggling learners to simply do more. We should help them practice more deliberately.
By identifying the specific skill behind a learner’s difficulty and connecting that learner with targeted practice, educators can turn remediation from a broad response to poor performance into a focused strategy for growth.
Aquifer can help make that strategy practical—giving faculty a library of authentic clinical learning experiences and resources that can be selected intentionally based on what an individual learner needs next.
Explore the companion, Helping the Struggling Learner: Learner Supports, for suggested Aquifer cases and tools aligned with common learner challenges.